Tricuspid stenosis physical examination: Difference between revisions
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===Vital signs=== | ===Vital signs=== | ||
A [[pulsus paradoxus]] may be present | *A [[pulsus paradoxus]] may be present | ||
===Neck=== | ===Neck=== | ||
An elevated [[jugular venous pulse]] may be present | *An elevated [[jugular venous pulse]] may be present | ||
===Heart=== | ===Heart=== | ||
A mid [[diastolic]] [[heart murmur|murmur]] can be heard during [[auscultation]] caused by the blood flow through the stenotic valve | *A mid [[diastolic]] [[heart murmur|murmur]] can be heard during [[auscultation]] | ||
**This is caused by the blood flow through the stenotic valve | |||
**This is best heard over the left [[sternum|sternal]] border with rumbling character and [[heart sounds|tricuspid opening snap]] with [[heart sounds|wide splitting S1]] | |||
**The murmur of tricuspid stenosis may increase in intensity with [[inspiration]] (Carvallo's sign) | |||
*[[Jugular Venous Pulse]]: | |||
**Sinus rhythm: jugular venous pulse increases and A wave is prominent | |||
***This may be confused with arterial pulse | |||
**Atrial fibrillation: A wave is lost | |||
*Patients with tricuspid stenosis may feature a prominent right atrium palpable to the right of the sternum | |||
**A tricuspid opening snap may be heard if it not obscured by the sounds of mitral stenosis | |||
**At either the left sternal border or at the [[xiphoid process]], a [[diastolic murmur]] can be heard, increasing with inspiration | |||
**[[Tricuspid regurgitation]] oftentimes presents in a similar location, delineated by a [[holosystolic murmur]] | |||
===Abdominal=== | |||
*Patients frequently experience [[peripheral edema]] and [[ascites]] | |||
===Severity of Disease Presence=== | |||
*If patients do not have significant mitral pathology, they will most likely not experience [[dyspnea]] | |||
**Patients may be able to lay flat without symptoms | |||
==References== | ==References== | ||
Revision as of 20:21, 19 July 2011
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Tricuspid stenosis Microchapters |
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Tricuspid stenosis physical examination On the Web |
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American Roentgen Ray Society Images of Tricuspid stenosis physical examination |
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Risk calculators and risk factors for Tricuspid stenosis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Physical Examination
Vital signs
- A pulsus paradoxus may be present
Neck
- An elevated jugular venous pulse may be present
Heart
- A mid diastolic murmur can be heard during auscultation
- This is caused by the blood flow through the stenotic valve
- This is best heard over the left sternal border with rumbling character and tricuspid opening snap with wide splitting S1
- The murmur of tricuspid stenosis may increase in intensity with inspiration (Carvallo's sign)
- Jugular Venous Pulse:
- Sinus rhythm: jugular venous pulse increases and A wave is prominent
- This may be confused with arterial pulse
- Atrial fibrillation: A wave is lost
- Sinus rhythm: jugular venous pulse increases and A wave is prominent
- Patients with tricuspid stenosis may feature a prominent right atrium palpable to the right of the sternum
- A tricuspid opening snap may be heard if it not obscured by the sounds of mitral stenosis
- At either the left sternal border or at the xiphoid process, a diastolic murmur can be heard, increasing with inspiration
- Tricuspid regurgitation oftentimes presents in a similar location, delineated by a holosystolic murmur
Abdominal
- Patients frequently experience peripheral edema and ascites
Severity of Disease Presence
- If patients do not have significant mitral pathology, they will most likely not experience dyspnea
- Patients may be able to lay flat without symptoms