Atrial fibrillation physical examination: Difference between revisions
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===Vital Signs=== | ===Vital Signs=== | ||
* [[Temperature]]: In the setting of drug toxicity or [[hypothermia]], the pulse may be slower. | *[[Temperature]] | ||
* [[ | *[[Pulse]]: | ||
* [[Blood pressure]]: The blood pressure should be checked as [[hypertension]] is one of the leading causes of atrial fibrillation. Narrow [[pulse pressure]] (systolic blood pressure minus diastolic blood pressure is < 25 mm Hg) usually suggest congestive heart failure. | **In the setting of [[drug]] [[toxicity]] or [[hypothermia]], the [[pulse]] may be slower. | ||
**The [[pulse]] is [[Irregularly irregular pulse|irregularly irregular]]. In general the [[heart rate]] is 100-140 beats per minute. | |||
**In the presence of [[atrial fibrillation]] the [[pulse]] could be 150-170 beats per minute (rare). | |||
*[[Blood pressure]]: | |||
**The [[blood pressure]] should be checked as [[hypertension]] is one of the leading causes of [[atrial fibrillation]]. | |||
**Narrow [[pulse pressure]] (when [[Blood pressure|systolic blood pressure]] minus [[Blood pressure|diastolic blood pressure]] is < 25 mm Hg) usually suggest [[congestive heart failure]]. | |||
===Eye=== | ===Eye=== |
Revision as of 09:52, 24 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The hemodynamic stability of the patient should be first assessed. The patient should also be examined for the presence of reversible causes of atrial fibrillation. A study of routine pulse checks or electrocardiograms during routine office visits, found that the annual rate of detection of atrial fibrillation in elderly patients improved from 1.04% to 1.63%.[1] This implies that the sensitivity of the routine examination is 64% (1.04/1.63).
Physical Examination
Vital Signs
- Temperature
- Pulse:
- In the setting of drug toxicity or hypothermia, the pulse may be slower.
- The pulse is irregularly irregular. In general the heart rate is 100-140 beats per minute.
- In the presence of atrial fibrillation the pulse could be 150-170 beats per minute (rare).
- Blood pressure:
- The blood pressure should be checked as hypertension is one of the leading causes of atrial fibrillation.
- Narrow pulse pressure (when systolic blood pressure minus diastolic blood pressure is < 25 mm Hg) usually suggest congestive heart failure.
Eye
- Exopthalmos may suggest hyperthyroidism.
- Retinal hemorrhage may be seen in malignant hypertension
Neck
- The patient should be examined for the presence of thyroid abnormalities.
Heart
- The patient should be examined to assess for the presence of congestive heart failure or hypertrophic obstructive cardiomyopathy.
- S3 and S4 would suggest heart failure.
- Heart murmurs, their intensity, postural changes can identify different valvular heart diseases.
Lung
- Rales would suggest heart failure.
Lower Extremities
- Lower leg edema may suggest cardiac failure.
References
- ↑ Fitzmaurice DA, Hobbs FD, Jowett S; et al. (2007). "Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial". doi:10.1136/bmj.39280.660567.55. PMID 17673732.