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{{Dilated cardiomyopathy}}
{{Dilated cardiomyopathy}}
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== Overview ==
Patients with [[dilated cardiomyopathy]] (DCM) usually appear lethargic and may display the general appearance of [[Congestive heart failure|heart failure]]. [[Physical examination]] of patients with DCM is usually remarkable for cardiac examination findings (lateral displacement of the [[Displaced point of maximal impulse|point of maximal impulse]], right ventricular [[heave]], [[S2|S<sub>2</sub>]] at the base, and S3 [[Gallop rhythm|gallops]]), [[jugular venous distension]], and [[Pedal edema|peripheral edema]].


{{CMG}}
== Physical Examination ==
The [[physical examination]] of patients with [[dilated cardiomyopathy]] may show:<ref name="pmid1507837">{{cite journal| author=Amosova EN| title=[Differential diagnosis of dilated cardiomyopathy]. | journal=Klin Med (Mosk) | year= 1992 | volume= 70 | issue= 3-4 | pages= 14-9 | pmid=1507837 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1507837  }}</ref><ref name="pmid15078372">{{cite journal| author=Amosova EN| title=[Differential diagnosis of dilated cardiomyopathy]. | journal=Klin Med (Mosk) | year= 1992 | volume= 70 | issue= 3-4 | pages= 14-9 | pmid=1507837 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1507837  }}</ref><ref name="pmid14598597">{{cite journal| author=Gurevich MA, Gordienko BV| title=[Dilated and ischemic cardiomyopathy: differential diagnosis]. | journal=Klin Med (Mosk) | year= 2003 | volume= 81 | issue= 9 | pages= 68-71 | pmid=14598597 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14598597  }}</ref><ref name="pmid145985972">{{cite journal| author=Gurevich MA, Gordienko BV| title=[Dilated and ischemic cardiomyopathy: differential diagnosis]. | journal=Klin Med (Mosk) | year= 2003 | volume= 81 | issue= 9 | pages= 68-71 | pmid=14598597 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14598597  }}</ref>


==Overview==
=== Appearance of the Patient ===


==Physical Examination==
* Patients with DCM usually appear lethargic and may display the general appearance of [[Congestive heart failure|heart failure]].


The clinical presentation of dilated cardiomyopathy is similar to that [[heart failure]] from any cause.  [[Dyspnea]] on exertion, [[orthopnea]], [[paroxysmal nocturnal dyspnea]], lower extremity [[edema]] and [[orthostasis]] / [[syncope]] are all common findings in dilated cardiomyopathy.  In addition, dilated cardiomyopathy may present as [[palpitations]] as a result of [[arrhythmia]] (ventricular or atrial) with the most common arrhythmia being [[atrial fibrillation]].  Dilated cardiomyopathy may also present as [[sudden cardiac death]] or as CVA ([[cerebrovascular accident]]) or other embolic phenomenon (either from associated atrial fibrillation or from ventricular thrombi as a result of dilated ventricular cavities). 
=== Vital Signs ===


[[Angina]] is not a common feature of dilated cardiomyopathy unless the cause is related to coronary artery disease.  If angina is present a work up for [[cardiac ischemia]] should be undertaken.<ref> Mayo Clinic Cardiology. Concise Textbook. Murphy, Joseph G; Lloyd, Margaret A. Mayo Clinic Scientific Press. 2007.</ref>
* [[Tachycardia]] with regular or irregular pulse (in case of atrial fibrillation)
* Tachypnea
* Weak pulse (low pulse pressure)
* Low [[Blood pressure low, systemic|blood pressure]] may be present
 
=== Skin ===
 
* [[Cyanosis]]
* [[Pallor]] in case of [[Congestive heart failure|heart failure]].
 
=== HEENT ===
 
* HEENT examination of patients with [[Dilated cardiomyopathy|DCM]] is usually normal
 
=== Neck ===
 
* [[Jugular venous distension]]
 
=== Lungs ===
 
* Fine [[crackles]] upon [[auscultation]] of the lung bases bilaterally
 
=== Heart ===
 
* Lateral displacement of the point of maximal impulse (PMI)
*Right ventricular heave
*[[S2|S<sub>2</sub>]] at the base (paradoxical splitting, prominent P<sub>2</sub>)
* [[Heart sounds#Summation%20Gallop|S3 Gallops]]
*[[Atrial fibrillation]] may be present
 
=== Abdomen ===
 
*[[Hepatomegaly]] in heart failure
 
=== Back ===
 
* Back examination of patients with [[Dilated cardiomyopathy|DCM]] is usually normal
 
=== Genitourinary ===
 
*[[Genitourinary system|Genitourinary]] examination of patients with [[Dilated cardiomyopathy|DCM]] is usually normal.
 
=== Neuromuscular ===
 
*[[Neuromuscular]] examination of patients with DCM is usually normal
 
=== Extremities ===
 
*[[Cyanosis]]
*[[Clubbing]]
* Pitting [[edema]] of the upper/lower extremities in heart fai__NOTOC__lure
{{Dilated cardiomyopathy}}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Needs content]]
[[Category:Disease]]
[[Category:Cardiomyopathy]]
[[Category:Cardiology]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]
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Latest revision as of 17:18, 30 December 2019

Dilated cardiomyopathy Microchapters

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Directions to Hospitals Treating Dilated cardiomyopathy

Risk calculators and risk factors for Dilated cardiomyopathy physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]

Overview

Patients with dilated cardiomyopathy (DCM) usually appear lethargic and may display the general appearance of heart failure. Physical examination of patients with DCM is usually remarkable for cardiac examination findings (lateral displacement of the point of maximal impulse, right ventricular heave, S2 at the base, and S3 gallops), jugular venous distension, and peripheral edema.

Physical Examination

The physical examination of patients with dilated cardiomyopathy may show:[1][2][3][4]

Appearance of the Patient

  • Patients with DCM usually appear lethargic and may display the general appearance of heart failure.

Vital Signs

  • Tachycardia with regular or irregular pulse (in case of atrial fibrillation)
  • Tachypnea
  • Weak pulse (low pulse pressure)
  • Low blood pressure may be present

Skin

HEENT

  • HEENT examination of patients with DCM is usually normal

Neck

Lungs

Heart

  • Lateral displacement of the point of maximal impulse (PMI)
  • Right ventricular heave
  • S2 at the base (paradoxical splitting, prominent P2)
  • S3 Gallops
  • Atrial fibrillation may be present

Abdomen

Back

  • Back examination of patients with DCM is usually normal

Genitourinary

Neuromuscular

Extremities

Dilated cardiomyopathy Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Classification

Causes

Differentiating Dilated cardiomyopathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Dilated cardiomyopathy physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Dilated cardiomyopathy 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 Dilated cardiomyopathy physical examination

CDC on Dilated cardiomyopathy physical examination

Dilated cardiomyopathy physical examination in the news

Blogs on Dilated cardiomyopathy physical examination

Directions to Hospitals Treating Dilated cardiomyopathy

Risk calculators and risk factors for Dilated cardiomyopathy physical examination

References

  1. Amosova EN (1992). "[Differential diagnosis of dilated cardiomyopathy]". Klin Med (Mosk). 70 (3–4): 14–9. PMID 1507837.
  2. Amosova EN (1992). "[Differential diagnosis of dilated cardiomyopathy]". Klin Med (Mosk). 70 (3–4): 14–9. PMID 1507837.
  3. Gurevich MA, Gordienko BV (2003). "[Dilated and ischemic cardiomyopathy: differential diagnosis]". Klin Med (Mosk). 81 (9): 68–71. PMID 14598597.
  4. Gurevich MA, Gordienko BV (2003). "[Dilated and ischemic cardiomyopathy: differential diagnosis]". Klin Med (Mosk). 81 (9): 68–71. PMID 14598597.

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