Chest pain physical examination
Physical Examination
Vitals
- Temperature (pericarditis, pleuritis, fever can precipitate ischemic attacks)
- Absent or decreased pulses in limbs (aortic dissection all four limbs), tachycardia (pulmonary embolism)
- Blood pressure in both the arms (aortic dissection)
Neck
- Elevated jugular venous pulse
Cardiovascular
- Auscultation
- Third and fourth heart sound
- Carotid bruit
- Pericardial rub (pericarditis)
- Murmur (systoloic murmur in Hypertrohic cardiomyopathy, aortic stenosis)
Pulmonary
- Palpation - shift in trachea from midline (tension pneumothorax)
- Auscultation - Decreased breath sound (pulmonary edema), pleural rub (pleuritis, pneumonia)
Central nervous system
- Cerebrovascular accidents (aortic dissection)
- Paraplegia
Genitourinary system
- Rectal examination - occult bleeding (peptic ulcers)