Dilated cardiomyopathy physical examination: Difference between revisions

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== Overview ==
== Overview ==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Patients with dilated cardiomyopathy (DCM) usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].


== Physical Examination ==
== Physical Examination ==
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* High-grade / low-grade fever
* High-grade / low-grade fever
* [[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
* [[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
* [[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
* Tachypnea / bradypnea
* Tachypnea / bradypnea
* Kussmal respirations may be present in _____ (advanced disease state)
* Kussmal respirations may be present in _____ (advanced disease state)
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* [[Cyanosis]]
* [[Cyanosis]]
* [[Pallor]]
* [[Pallor]] in case of heart failure.


=== HEENT ===
=== HEENT ===


* Abnormalities of the head/hair may include ___
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]
* [[Nystagmus]]
* Extra-ocular movements may be abnormal
* Extra-ocular movements may be abnormal
* Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
* Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
* Ophthalmoscopic exam may be abnormal with findings of ___
* Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced


=== Neck ===
=== Neck ===


* [[Jugular venous distension]]
* [[Jugular venous distension]]
* [[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
* [[Hepatojugular reflux]]


=== Lungs ===
=== Lungs ===


* Asymmetric chest expansion OR decreased chest expansion
* Lungs are hyporesonant OR hyperresonant
* Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
* Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
* Rhonchi
* Rhonchi
* Vesicular breath sounds OR distant breath sounds
* Vesicular breath sounds OR distant breath sounds
* Expiratory wheezing OR inspiratory wheezing with normal OR delayed expiratory phase
* [[Wheezing]] may be present
* [[Egophony]] present/absent
* [[Bronchophony]] present/absent
* Normal/reduced [[tactile fremitus]]
* Normal/reduced [[tactile fremitus]]


=== Heart ===
=== Heart ===


* Chest tenderness upon palpation
* PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
* PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
* [[Heave]] / [[thrill]]
* [[Heave]] / [[thrill]]
* [[Friction rub]]
* [[Friction rub]]
* [[Heart sounds#First%20heart%20tone%20S1.2C%20the%20.22lub.22.28components%20M1%20and%20T1.29|S1]]
* [[Heart sounds#Summation%20Gallop|S3 Gallops]]
* [[Heart sounds#Second%20heart%20tone%20S2%20the%20.22dub.22.28components%20A2%20and%20P2.29|S2]]
* [[Heart sounds#Third%20heart%20sound%20S3|S3]]
* [[Heart sounds#Fourth%20heart%20sound%20S4|S4]]
* [[Heart sounds#Summation%20Gallop|Gallops]]
* A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the stethoscope
* A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the stethoscope



Revision as of 17:15, 9 December 2019

Overview

Patients with dilated cardiomyopathy (DCM) usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

Physical Examination

Appearance of the Patient

  • Patients with DCM usually appear [general appearance].

Vital Signs

  • High-grade / low-grade fever
  • Tachycardia with regular pulse or (ir)regularly irregular pulse
  • Tachypnea / bradypnea
  • Kussmal respirations may be present in _____ (advanced disease state)
  • Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
  • High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure

Skin

HEENT

  • Nystagmus
  • Extra-ocular movements may be abnormal
  • Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
  • Ophthalmoscopic exam may be abnormal with findings of ___

Neck

Lungs

  • Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
  • Rhonchi
  • Vesicular breath sounds OR distant breath sounds
  • Normal/reduced tactile fremitus

Heart

Abdomen

Back

  • Back examination of patients with DCM is usually normal

Genitourinary

  • Genitourinary examination of patients with DCM is usually normal.

Neuromuscular

  • Neuromuscular examination of patients with [disease name] is usually normal.

OR

  • Patient is usually oriented to persons, place, and time
  • Altered mental status
  • Glasgow coma scale is ___ / 15
  • Clonus may be present

Extremities

  • Cyanosis
  • Pitting/non-pitting edema of the upper/lower extremities

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