Tuberculous pericarditis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Fahimeh Shojaei, M.D. Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview

Patients with tuberculous pericarditis usually appear Cachectic. They may have fever, tachycardia, pulsus paradoxus, hypotension, tachypnea, JVP distension, kussmaul's sign, lymphadenopathy, ankle edama, pleura dullness, decreased breath sounds, pericardial knock, pericardial rub, fine/coarse crackles upon auscultation of the lung, hepatomegaly, ascites, distant heart sounds, displaced point of maximal impulse (PMI) suggestive of cardiomegaly, friction rub, and S4.

Physical Examination

Appearance of the Patient

  • Patients with tuberculous pericarditis usually appear Cachectic.[1][2]

Vital Signs

Skin

  • Skin examination of patients with tuberculous pericarditis is usually normal.

HEENT

  • HEENT examination of patients with tuberculous pericarditis is usually normal.

Neck

Lungs

  • Pleura dullness
  • Decreased breath sounds
  • Pericardial knock
  • Pericardial rub
  • Fine/coarse crackles upon auscultation of the lung

Heart

Abdomen

Back

  • Back examination of patients with tuberculous pericarditis is usually normal.

Genitourinary

  • Genitourinary examination of patients with tuberculous pericarditis is usually normal.

Neuromuscular

  • Neuromuscular examination of patients with tuberculous pericarditis is usually normal.

Extremities

  • Pitting edema of the lower extremities

References

  1. Fowler NO, Manitsas GT (1973). "Infectious pericarditis". Prog Cardiovasc Dis. 16 (3): 323–36. doi:10.1016/s0033-0620(73)80004-0. PMID 4593515.
  2. Mayosi, Bongani M; Wiysonge, Charles Shey; Ntsekhe, Mpiko; Volmink, Jimmy A; Gumedze, Freedom; Maartens, Gary; Aje, Akinyemi; Thomas, Baby M; Thomas, Kandathil M; Awotedu, Abolade A; Thembela, Bongani; Mntla, Phindile; Maritz, Frans; Blackett, Kathleen Ngu; Nkouonlack, Duquesne C; Burch, Vanessa C; Rebe, Kevin; Parish, Andy; Sliwa, Karen; Vezi, Brian Z; Alam, Nowshad; Brown, Basil G; Gould, Trevor; Visser, Tim; Shey, Muki S; Magula, Nombulelo P; Commerford, Patrick J (2006). "Clinical characteristics and initial management of patients with tuberculous pericarditis in the HIV era: the Investigation of the Management of Pericarditis in Africa (IMPI Africa) registry". BMC Infectious Diseases. 6 (1). doi:10.1186/1471-2334-6-2. ISSN 1471-2334.

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