Secondary hyperaldosteronism physical examination
Overview
Patients with secondary hyperaldosteronism usually appear well. Physical examination of patients with secondary hyperaldosteronism is usually remarkable for high blood pressure, tachycardia, and an S4 maybe heard on auscultation of the precordium suggesting left ventricular hypertrophy secondary to increased afterload due to hypertension.
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Physical Examination
Appearance of the patient
- Patient is usually well-appearing
Vital signs
- Normal body temperature
- Tachycardia with irregular pulse[1][2]
- Normal respiratory rate
- High blood pressure may be the only presenting sign
Skin
- There are no abnormal skin findings associated with primary hyperaldosteronism
HEENT
- HEENT examination is normal in primary hyperaldosteronism.
Neck
- No lymphadenopathy
- No thyromegaly
- Elevated JVP
Lungs
- Symmetric chest expansion
- Normal breath sounds
- No rales, rhochi and wheeze
- Egophony absent
- Bronchophony absent
- Normal tactile fremitus
Heart
- No chest tenderness on palpation
- PMI within 2 cm of the sternum
- S1
- S2
- S4 may be heard due to left ventricular hypertrophy[3]
- No gallop rhythm
- Ventricular fibrillation may be a finding in primary hyperaldosteronism[4]
Abdomen
- Non-tender
- Non-distended
- No abnormal fluids or gas
- No palpable organomegaly
Back
- There are no abnormal findings on the back associated with primary hyperaldosteronism.
Genitourinary
- There are no abnormal genitourinary findings associated with primary hyperaldosteronism
Extremities
- Extremities are normal on examination in primary hyperaldosteronism
Neurologic
- Hyperaldosteronism induced hypertension may lead to stroke and paralysis[5]
References
- ↑ Zelinka T, Holaj R, Petrák O, Strauch B, Kasalický M, Hanus T, Melenovský V, Vancura V, Bürgelová M, Widimský J (2009). "Life-threatening arrhythmia caused by primary aldosteronism". Med. Sci. Monit. 15 (12): CS174–7. PMID 19946238.
- ↑ Pella J, Lazúrová I, Javorská B, Trejbal D (1999). "[Conn's syndrome and severe arrhythmias]". Vnitr Lek (in Slovak). 45 (4): 228–31. PMID 11045185.
- ↑ du Cailar G (2004). "[Cardiac consequences of primary hyperaldosteronism]". Ann Cardiol Angeiol (Paris) (in French). 53 (3): 147–9. PMID 15291171.
- ↑ Delgado Y, Quesada E, Pérez Arzola M, Bredy R (2006). "Ventricular fibrillation as the first manifestation of primary hyperaldosteronism". Bol Asoc Med P R. 98 (4): 258–62. PMID 19610566.
- ↑ Nishimura M, Uzu T, Fujii T, Kuroda S, Nakamura S, Inenaga T, Kimura G (1999). "Cardiovascular complications in patients with primary aldosteronism". Am. J. Kidney Dis. 33 (2): 261–6. PMID 10023636.