Congenital heart disease physical examination: Difference between revisions
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{{Congenital heart disease}} | {{Congenital heart disease}} | ||
{{CMG}} {{AE}} {{KD}} | {{CMG}} {{AE}} {{KD}} | ||
==Physical Examination== | ==Physical Examination== | ||
===Pulse=== | |||
* [[Tachycardia]] may be present | * [[Tachycardia]] may be present | ||
===Respiratory Rate=== | |||
* [[Tachypnea]] may be present | * [[Tachypnea]] may be present | ||
===Eyes=== | |||
* [[Retinopathy]] | |||
===Chest=== | ===Chest=== | ||
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===Heart=== | ===Heart=== | ||
====Inspection==== | |||
* Precordial bulge may be present | * Precordial bulge may be present | ||
====Palpation==== | |||
* [[Thrill]] due to outflow tract obstruction or a restrictive ventricular septal defect | * [[Thrill]] due to outflow tract obstruction or a restrictive ventricular septal defect | ||
* Increased apical activity suggestive of left ventricular volume or pressure overload | * Increased apical activity suggestive of left ventricular volume or pressure overload | ||
====Auscultation==== | |||
* A single second heart sound occurs in the following conditions: | * A single second heart sound occurs in the following conditions: | ||
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* Early systolic clicks, which occur with [[semilunar valve stenosis]], [[bicuspid aortic valve]], and [[Persistent truncus arteriosus|truncus arteriosus]]. | * Early systolic clicks, which occur with [[semilunar valve stenosis]], [[bicuspid aortic valve]], and [[Persistent truncus arteriosus|truncus arteriosus]]. | ||
* Mid-systolic clicks, which are heard with [[mitral valve prolapse]] and with [[ | * Mid-systolic clicks, which are heard with [[mitral valve prolapse]] and with [[ebstein's anomaly of the tricuspid valve]]. | ||
* An S3 gallop, which, in infants, can result from ventricular dysfunction | * An S3 gallop, which, in infants, can result from ventricular dysfunction | ||
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** [[Tetralogy of fallot]]: A harsh systolic ejection murmur best heard at the left sternal border is usually present. | ** [[Tetralogy of fallot]]: A harsh systolic ejection murmur best heard at the left sternal border is usually present. | ||
** [[Persistent truncus arteriosus]]: Systole ejection murmur is heard at the left sternal border | ** [[Persistent truncus arteriosus]]: Systole ejection murmur is heard at the left sternal border | ||
** [[Transposition of the great vessels]]: The murmur of a large PDA in d-TGA, is usually systolic, seldom continuos, due to the almost exclusive flow during systole from the aorta to the pulmonary artery. Systolic murmurs are absent | ** [[Transposition of the great vessels]]: The murmur of a large PDA in d-TGA, is usually systolic, seldom continuos, due to the almost exclusive flow during systole from the aorta to the pulmonary artery. Systolic murmurs are absent in neonates unless a subpulmonic stenosis is present | ||
** [[Total anomalous pulmonary venous connection]]: Systolic ejection [[murmur]] is heard at left upper sternal border. Diastolic murmur due to tricuspid regurgitation is also heard. | ** [[Total anomalous pulmonary venous connection]]: Systolic ejection [[murmur]] is heard at left upper sternal border. Diastolic murmur due to tricuspid regurgitation is also heard. | ||
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{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Needs content]] | |||
[[Category:Needs overview]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Congenital heart disease]] | [[Category:Congenital heart disease]] | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
Latest revision as of 21:03, 4 March 2013
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Congenital heart disease Microchapters |
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Differentiating Congenital heart disease from other Disorders |
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Diagnosis |
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Treatment |
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Case Studies |
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Congenital heart disease physical examination On the Web |
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American Roentgen Ray Society Images of Congenital heart disease physical examination |
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Risk calculators and risk factors for Congenital heart disease physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Physical Examination
Pulse
- Tachycardia may be present
Respiratory Rate
- Tachypnea may be present
Eyes
Chest
- Wheezing may be present
Heart
Inspection
- Precordial bulge may be present
Palpation
- Thrill due to outflow tract obstruction or a restrictive ventricular septal defect
- Increased apical activity suggestive of left ventricular volume or pressure overload
Auscultation
- A single second heart sound occurs in the following conditions:
- Aortic atresia
- Pulmonary atresia
- Truncus arteriosus
- Conditions with pulmonary hypertension
- Widely or fixed split S2 occurs with atrial septal defect
- Early systolic clicks, which occur with semilunar valve stenosis, bicuspid aortic valve, and truncus arteriosus.
- Mid-systolic clicks, which are heard with mitral valve prolapse and with ebstein's anomaly of the tricuspid valve.
- An S3 gallop, which, in infants, can result from ventricular dysfunction
- Murmurs
- Atrial septal defect: Systolic murmur heard best at the left upper sternal border
- Ventricular septal defect: Holosytolic murmur heard best at the left upper sternal border
- Patent ductus arteriosus: Machinery murmur heard best in the left infraclavicular region
- Tetralogy of fallot: A harsh systolic ejection murmur best heard at the left sternal border is usually present.
- Persistent truncus arteriosus: Systole ejection murmur is heard at the left sternal border
- Transposition of the great vessels: The murmur of a large PDA in d-TGA, is usually systolic, seldom continuos, due to the almost exclusive flow during systole from the aorta to the pulmonary artery. Systolic murmurs are absent in neonates unless a subpulmonic stenosis is present
- Total anomalous pulmonary venous connection: Systolic ejection murmur is heard at left upper sternal border. Diastolic murmur due to tricuspid regurgitation is also heard.
Abdomen
- Hepatomegaly often occurs in patient with congestive heart failure.
Extremities
- Skeletal abnormalities, especially those of the hand and arm, are often associated with cardiac malformations.