Difference between revisions of "Atrial flutter physical examination"

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(Physical Examination)
(Heart)
 
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===Skin===
 
===Skin===
* Skin examination of patients with [disease name] is usually normal.
+
* Skin examination of patients with atrial flutter is usually normal.
OR
 
*[[Cyanosis]]
 
*[[Jaundice]]
 
* [[Pallor]]
 
* Bruises
 
 
 
<gallery widths="150px">
 
 
 
UploadedImage-01.jpg | Description {{dermref}}
 
UploadedImage-02.jpg | Description {{dermref}}
 
 
 
</gallery>
 
  
 
===HEENT===
 
===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
+
*Exophthalmos and neck swelling can be seen in hyperthyroidism.
OR
 
* Abnormalities of the head/hair may include ___
 
* Evidence of trauma
 
* Icteric sclera
 
* [[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 ___
 
* Hearing acuity may be reduced
 
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
 
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
 
* [[Exudate]] from the ear canal
 
* Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
 
*Inflamed nares / congested nares
 
* [[Purulent]] exudate from the nares
 
* Facial tenderness
 
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
 
  
 
===Neck===
 
===Neck===
* Neck examination of patients with [disease name] is usually normal.
+
* Neck examination of patients with atrial flutter is usually normal.
OR
 
*[[Jugular venous distension]]
 
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
 
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
 
*[[Thyromegaly]] / thyroid nodules
 
*[[Hepatojugular reflux]]
 
  
 
===Lungs===
 
===Lungs===
* Pulmonary examination of patients with [disease name] is usually normal.
+
* Pulmonary examination of patients with atrial flutter is usually normal.
OR
 
* Asymmetric chest expansion OR decreased chest expansion
 
*Lungs are hyporesonant OR hyperresonant
 
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
 
*Rhonchi
 
*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]]
 
  
 
===Heart===
 
===Heart===
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*[[Heart sounds#Summation Gallop|Gallops]]
 
*[[Heart sounds#Summation Gallop|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
 +
*S3 may be heard in congestive heart failure. A mid-to-late systolic click is present, followed by a late systolic murmur which is best heard at the cardiac apex is observed in mitral valve prolapse. Similarly a holosystolic murmur is heard in mitral regurgitation due to rheumatic heart disease.
  
 
===Abdomen===
 
===Abdomen===

Latest revision as of 18:31, 4 December 2019

Atrial flutter Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Atrial flutter from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples

Chest X Ray

Echocardiography

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

2015 ACC/AHA Guideline Recommendations

Acute Treatment of Atrial Flutter
Ongoing Management of Atrial Flutter

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Atrial flutter physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Atrial flutter physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Atrial flutter physical examination

CDC on Atrial flutter physical examination

Atrial flutter physical examination in the news

Blogs on Atrial flutter physical examination

Directions to Hospitals Treating Atrial flutter

Risk calculators and risk factors for Atrial flutter physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

The patient should first be assessed for hemodynamic instability. The patient should also be examined for the presence of reversible causes of atrial flutter.

Physical Examination

Vitals

Temperature

Fever may be present.

Pulse

Pulse is usually rapid and may be regular or irregular. Ventricular rate is around 150 beats per minute because of 2:1 conduction. 1:1 ventricular conduction is fatal.

Blood pressure

Hypertension may be present.

Head and Neck

Exophthalmos and neck swelling can be seen in hyperthyroidism.

Heart

Auscultation

S3 may be heard in congestive heart failure. A mid-to-late systolic click is present, followed by a late systolic murmur which is best heard at the cardiac apex is observed in mitral valve prolapse. Similarly a holosystolic murmur is heard in mitral regurgitation due to rheumatic heart disease.


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

OR

Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Appearance of the Patient

  • Patients with [disease name] usually appear [general appearance].

Vital Signs

  • High-grade / low-grade fever
  • Hypothermia / hyperthermia may be present
  • Tachycardia with regular pulse or (ir)regularly irregular pulse
  • Bradycardia 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

  • Skin examination of patients with atrial flutter is usually normal.

HEENT

  • Exophthalmos and neck swelling can be seen in hyperthyroidism.

Neck

  • Neck examination of patients with atrial flutter is usually normal.

Lungs

  • Pulmonary examination of patients with atrial flutter is usually normal.

Heart

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

OR

  • Chest tenderness upon palpation
  • PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
  • Heave / thrill
  • Friction rub
  • S1
  • S2
  • S3
  • S4
  • 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
  • S3 may be heard in congestive heart failure. A mid-to-late systolic click is present, followed by a late systolic murmur which is best heard at the cardiac apex is observed in mitral valve prolapse. Similarly a holosystolic murmur is heard in mitral regurgitation due to rheumatic heart disease.

Abdomen

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

OR

Back

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

OR

  • Point tenderness over __ vertebrae (e.g. L3-L4)
  • Sacral edema
  • Costovertebral angle tenderness bilaterally/unilaterally
  • Buffalo hump

Genitourinary

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

OR

  • A pelvic/adnexal mass may be palpated
  • Inflamed mucosa
  • Clear/(color), foul-smelling/odorless penile/vaginal discharge

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
  • Hyperreflexia / hyporeflexia / areflexia
  • Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
  • Muscle rigidity
  • Proximal/distal muscle weakness unilaterally/bilaterally
  • ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
  • Unilateral/bilateral upper/lower extremity weakness
  • Unilateral/bilateral sensory loss in the upper/lower extremity
  • Positive straight leg raise test
  • Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
  • Positive/negative Trendelenburg sign
  • Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
  • Normal finger-to-nose test / Dysmetria
  • Absent/present dysdiadochokinesia (palm tapping test)

Extremities

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

OR

  • Clubbing
  • Cyanosis
  • Pitting/non-pitting edema of the upper/lower extremities
  • Muscle atrophy
  • Fasciculations in the upper/lower extremity

References


Cardiology


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