General Physical Examination in Cardiovascular Diseases
•Download as PPTX, PDF•
5 likes•374 views
This document provides an overview of the physical examination of the cardiovascular system. It describes examining the general appearance and various body systems including height, weight, eyes, nose, mouth, neck, skin, extremities and edema. Specific physical findings are associated with various cardiac conditions. For example, low set ears may indicate Noonan syndrome, thick lips can be seen in Hurler syndrome, and bronze pigmentation could indicate hemochromatosis with potential cardiomyopathy. The document provides a comprehensive guide to the physical exam and relating physical findings to possible underlying heart conditions.
More Related Content
What's hot
What's hot (20)
Similar to General Physical Examination in Cardiovascular Diseases
Similar to General Physical Examination in Cardiovascular Diseases (20)
More from Chetan Ganteppanavar
More from Chetan Ganteppanavar (20)
Recently uploaded
Recently uploaded (20)
General Physical Examination in Cardiovascular Diseases
- 1. GENERAL PHYSICAL EXAMINATION IN CARDIOVASCULAR SYSTEM CHAIR PERSON: Dr. Ameet V Khatawkar STUDENT: Dr. Veeresh B Hubballi
- 2. • 1. General Built and Stature • 2. Posture or Attitude • 3. Gestures and signs • 4. Facial appearance • 5. Eyes • 6. Nose • 7. Ears • 8. Oral cavity • 9. Neck • 10. Spine • 11. Skin • 11. Extremities • 12. Peripheral edema
- 3. • 1. GENERAL BUILT AND STATURE What all to see 1. Height 2. Weight 3. Upper and lower segments 4. Body mass index 5. Waist circumference
- 4. 1. SHORT STATURE: < 2SD or 4 feet i. Genetic ii. Skeletal iii.Endocrine iv.Constitutional
- 5. • 1. GENETIC CAUSES : 1. TURNERS SYNDROME : - COA, BAV, PAPVC
- 6. • 2. NOONAN SYNDROME: Dysplastic PS, HCM, ASD , VSD
- 7. • 2. ELLIS-VAN CREVELD SYNDROME: - Single atrium , ASD
- 8. 4. ACHONDROPLASIA: Increased risk of mortality due to cvs causes
- 9. • C 5. OSTEOGENESIS IMPERFECTA: Aortic root dilatation, Valvular insufficiency
- 11. GROTESQUE FACIES
- 15. 8. CRETINISM: Bradycardia , Heart blocks, Diastolic hypertension, Pericardial effusion
- 19. 10. CUSHING SYNDROME: Metabolic syndrome
- 20. 11. RICKETS: - Cardiomyopathy
- 21. 12. POTTS SPINE
- 23. 2. TALL STATURE: 2 SD or Height > 6feet
- 24. • ACROMEGALY – • Acromegalic cardiomyopathy
- 26. • MARFANS SYNDROME :
- 34. • LUMBO SCARAL DURAL ECTASIA
- 35. REVISED GHENTS CRITERIA: 1. Skeletal system 2. Ocular system 3. Cardiovascular system 4. Lungs 5. Skin 6. Dura
- 36. • SKELETAL SYSTEM: MAJOR SIGNS: FEW TAPPS 1. Flat foot 2. Elbow Extension reduced (<170°) 3. Wrist and thumb sign 4. Tall stature 5. Protrusio acetabulae 6. Pectus carinatum 7. Pectus excavatum requiring surgery 8. Scoliosis >20°
- 37. • MINOR SIGNS: 1. Pectus excavatum of moderate intensity 2. Hypermobility of joints 3. High arched palate 4. Abnormal facial appearance ORGAN INVOLVEMENT CRITERIA: 2 major signs or 1 major plus 2 minor signs
- 40. ,n • Venous thromboembolism • ASD KLIFELTERS SYNDROME:
- 41. 3. BUILT AND NOURISHMENT
- 45. • PICKWICKIAN SYNDROME- Pulmonary HTN , increased PVR
- 46. • Variable CHD
- 47. • 2. POSTURE AND ATTITUDE
- 50. GOWERS SIGN
- 51. • 1. Face – Facial dysmorphism, facies, local features • 2. Eyes • 3. Nose • 4. Ears • 5.Oral cavity • 6. Neck B. HEAD AND NECK
- 52. • 1. FACIAL DYSMPORPHISM: i. Hypertelorism ii. Epicanthic folds iii. Broad flat nose iv. Low set ears v. Thick lips vi. Abnormal teeth vii. Short neck viii.Low hair line
- 53. • HYPERTELORISM
- 54. Conditions Cardiac abnormaility Noonan syndrome PS Turner syndrome COA LEOPARD syndrome PS HCM Hurler syndrome Arrhythmias Valvular regurgtation William syndrome Supravalvular AS PS Klippel-Feil syndrome VSD
- 55. EPICANTHAL FOLDS
- 56. • LOWS SET EARS
- 57. CONDITIONS CARDIAC ABNORMALITY Downs syndrome Endocardial cushion defects Turners syndrome PS COA Noonan syndrome PS Klippel Feil syndrome VSD Dextrocardia Cri-du chat syndrome TAPVC VSD TOF Cornelia de Langes VSD PDA
- 60. MONGOLOID FACE
- 62. ELLFIN FCAIES
- 63. SENILE FACIES
- 66. LEOPARD SYNDROME- PS, AV blocks Cardiomyopathy
- 68. KEARNS- SAYRE SYNDROME- Av blocks, DCM, HCM
- 69. FACIAL EDEMA- Constrictive pericarditis, TR, SVC obstruction syndrome
- 71. MALAR RASH
- 72. FACIAL FLUSHING – AR, TR(CARCINOID SYNDROME)
- 74. EYES: 1. Hypertelorism 2. Exopthalmos 3. Enopthalmos - cachexia 4. Eye lids- lid lag , ptosis , xanthelasma 5. Conjunctiva- pallor, suffusion, petechae, conjunctivitis 6. Sclera 7. Cornea- arcus, clouding 8. Iris- brushfield spots, coloboma 9. Pupils- Argyl Robertson pupil 10. Lens- premature catarct , subluxation 11. Retina
- 75. Exopthalmos CV abnormaility Exophthalmic ophthalmoplegia Thyrotoxicosis Pulsatile exophthalmos pulsating earlobes severe TR EXOPTHALMOS
- 76. • Mobius sign- convergence abnormality
- 77. Ptosis CV abnormality Keans- sayre syndrome AV blocks DCM HCM Klippel- Feil syndrome VSD Dextrocardia Multiple lentigenes syndrome HCM PTOSIS
- 78. XANTHELASMA – Dyslipidemia CAD
- 79. CONJUNCTIVA Findings CV abnormality Pallor Anemia, shock Cyanosis CHD Petechiae/ subconjunctival hemorrhage Infective endocarditis Conjunctivitis with Arthritis and urethritis Reiters disease Pericarditis, AV blocks, AR
- 82. SCLERA Scleral abnormality CV condition Icterus CHF large pulmonary infarct Hemolysis due to prosthetic valves Infective endocarditias Drugs- ATT Blue sclera OI Ehler-Danlos syndrome Marfans syndrome Familial
- 84. CORNEA Corneal abnormality CV condition Corneal arcus Dyslipidemia Arcus senilis Old age Corneal clouding MPS 1 4 6
- 87. IRIS Iris findings Conditions CV abnormality Brushfield spots Downs syndrome Endocardial cushion defects Congenital coloboma Cat eye syndrome CHARGE SYNDROME TAPVC, TOF VSD AR, MR, Aortic root dilatation
- 88. LENS Lens findings Condition CV abnormality Premature cataract Myotonic muscular dystrophy Refsums disease Rubella Cardiomyopathy DCM HCM PDA Sunflower cataract Wilsons disease Cardiomyopthy arrhythmias Lens dislocation Marfans syndrome Homocystinuria Aortic root dilatation AR MVP Aortic and Pulmonary root dilatation Intravacular thrombosis
- 89. RUBELLA- PREMATURE CATARACT SUNFLOWER CATARACT
- 90. SUBLUXATION OF THE LENS
- 91. RETINA Retinal findings Conditions Hypertensive retinopathy HTN Arteriosclerotic retinopathy Atherosclersis Wreathlike AV anastomosis Takayasu arteritis Corckscrew tortous retinal arterie COA Roth spots IE Papilledema Malignant HTN Angioid streaks Pseudoxanthoma elasticum Pagets disease Sickle cell anemia OI
- 92. NORMAL FUNDUS
- 96. ROTH SPOTS
- 97. ANGIOID STREAKS
- 98. NOSE: Nose findings Conditions Broad flat nose Cornelia de Lange syndrome Down syndrome William syndrome Hurlers syndrome Broad nose Acromegaly Thin beaked nose Robinstein- Taybi syndrome PDA VSD
- 99. EAR ABNORMALITIES Ear findings Conditions Low set ears Noonan syndrome Turners syndrome Klippel-Feil syndrome Down syndrome Cornelia de Lange syndrome Rubintein – Taybi syndrome Defomed ears Polychondritis Ear lobe crease CAD Deafness Turners syndrome Klippel fleil syndrome Rubella Multiple lentigines syndrome Jervell and Lange-Nielson syndrome
- 100. MALFORMED EARS
- 101. TRANSVERSE EAR LOBE CREASE
- 102. TEETH ABNORMALITIES: 1. Peg shaped teeth 2. Widely spaced teeth 3. Malformed teeth - non hereditary forms of 4. Delayed dentition- cretins, monglosim, rickets 5. Malformed and premature dentition at birth- - Ellis Van Crevald syndrome
- 103. PEG SHAPED TEETH CONDITION CARDIAC ABNORMALITY HURLERS SYNDROME VI, COA WILLIAM SYNDROME SUPRAVALVILAR AS , PS CONGENITAL SYPHILIS ??
- 104. HURLERS SYNDROME
- 105. WILLIAMS SYNDROME
- 106. CONGENITAL SYPHILIS
- 107. WIDELY SPACED TEETH CONDITIONS CARDIAC ABNORMALITY ACROMEGALY Cardiomyopathy MORQUIOS SYNDROME Cardiomyopathy WILLIAM SYNDROME Supravalvular AS PS
- 108. MALFORMED TEETH: Non hereditary forms of supravalvular AS with PS
- 109. ELLIS VAN CREVELD SYNDROME
- 110. LIPS: Findings Conditions Pallor Anemia Cyanosis CHD Thick lips Hurler syndrome Acromegaly Myxedema Cretin Absent philtrum FAS Capillary pulsations AR Rhagades Congenital syphilis
- 112. GUMS: 1. Gum hyperplaisa - Phenytoin toxicity 2. Cyanosis- CHD
- 113. TONGUE: Tongue findings Condition Colour- Blue Scarlet red Magenta Black Pale tongue Cyanosis Niacin Riboflavin deficiency Actinomycosis IDA Shock Macroglossia Acromegaly Myxedema Downs syndrome Hurler syndrome Cretin Glossoptosis Pierre Robin syndrome
- 115. PALATE Palate findings Conditions High arched palate Marfans syndrome Pierre Robin syndrome Cleft/perforated palate Tertiary syphilis Velocardiofacial syndrome Tuberculosis Pierre Robin syndrome
- 116. HIGH ARCHED PALATE
- 117. CLEFT/PERFORATED PALATE Tertiary syphilis, velocardiofacial syndrome, TB, PR syndrome
- 118. NECK Short neck Webbed neck Low hair line Klippel-Feil syndrome Noonan syndrome Noonan syndrome Morquios syndrome Edwards syndrome Edwards syndrome Turners syndrome Turners syndrome Cornelia de Lange syndrome
- 119. LOW HAIR LINE
- 120. LYMPHAEDENOPTHY 1. Tuberculosis 2. Syphilis 3. Sarcoidosis
- 122. SPINE , SKIN AND EXTREMITIES A. SPINE: CONDITIONS CV ABNORMALITY 1. Marfan syndrome Dilatation of Aorta, AR, MVP+/- MR, MPA 2. Ankylosing spondylitis AR, MR,CHB 3. Straight back syndrome Mimics ASD
- 125. 2. SKIN Skin lesions and skin texture Xanthomas Nodules
- 126. SKIN MANIFESTATIO N CONDITION CV ABNORMALITY Bronze pigmentation Hemochromatosis Cardiomyopathy Café au luit spots Von Recklinghausen’s disease Pheochromocytoma -> hypertension and myocarditis Multiple lentigines LEOPARD syndrome Hypertrophic cardiomyopathy Angiofibromas Tuberous sclerosis Rhabdomyoma and arrhythmias Erythema marginatum Rheumatic fever Carditis Janeway lesions and Oslers nodes Infective endocarditis Valvular lesions and embolism
- 127. BRONZE PIGMENTATION
- 128. CAFÉ AU LUIT SPOTS
- 129. MULTIPLE LENTIGINES
- 130. ANGIOFIBROMAS
- 131. ERYTHEMA MARGINATUM
- 132. JANEWAY LESIONS
- 133. SKIN MANIFESTATIO N CONDITION CV ABNORMALITY Coarse skin Myxedema Pericardial effusion, atherosclerosis Hyperextensible and rubber like skin Ehler- Danlos syndrome Arterial dilatation and rupture, AR, MVP Plucked chicken appearance Pseudoxanthoma elasticum Premature calcification of systemic and coronary arteries, systemic HTN Moist silky skin Hyperthyroidism Arrhtymias, wide pulse pressue, high output failure
- 134. HYPEREXTENSIBLE AND RUBBER LIKE SKIN
- 136. MOIST SILKY SKIN
- 137. Xanthomas Hyperlipoproteinemia type Palmar xanthomas Type III Tendinous xanthomas Type II Eruptive xanthomas Types I and V Tuberous xanthomas Hyperlipidemia, myxedema Liver disorders
- 138. PALMAR XANTHOMAS
- 139. TENDINOUS XANTHOMAS
- 140. ERUPTIVE XANTHOMAS
- 141. TUBEROUS XANTHOMAS
- 142. C. EXTREMITIES/ LIMBS 1. Digits 2. Nails 3. Feet 4. Joints
- 143. Nodules Disease Waxy flat nodules Amyloidosis , restrictive cardiomyopathy Subcutaneous nodules Rheumatic fever, systemic lupus erythematosis, rheumatoid arthritis Osler’s node Infective endocarditis
- 144. WAXY FLAT NODULES
- 145. SUBCUTANEOUS NODULES RHEUMATIC FEVER RHEUMATOID ARTHRITIS
- 146. 1. ABNORMALITIES OF DIGITS Digits description Disease a. Arachnodactyly Marfan syndrome b. Polydactyly Ellis-van Creveld and Laurence-Moon-Biedl syndromes c. Syndactyly Ellis-van Creveld and Laurence-Moon-Biedl syndromes d. Clindactyly Down, Ellis-van Creveld and Hurler’s syndromes e. Brachydactyly Down and Turner syndromes, hyperparathyroidism f. Sclerodactyly Scleroderma
- 149. SCLERODACTYLY
- 150. 2. ABNORMALITIEES OF THUMB Abnormal thumbs Conditions CV abnormality Fingerized thumbs Holt-Oram syndrome ASD, VSD, Conduction defects Single thumb like digit Cornelia de Lange syndrome PS VSD COA Broad thumbs Rubinstein-Taybi syndrome ASD VSD PDA
- 151. FINGERIZED THUMBS
- 152. CORNELIA DE LANGE SYNDROME
- 154. 3. OTHERS: Abnormalities Conditions CV abnormality Clenched hands with index fingers overlapping third and fifth finger Edwards syndrome ASD VASD PDA Phocomelia Holt-Oram syndrome and Cornelia de Lange syndrome ASD Raynauds phenomenon Scleroderma Primary pulmonary hypertension
- 155. CLENCHED HANDS WITH INDEX FINGERS OVERLAPPING THIRD AND FIFTH FINGER
- 156. PHOCOMELIA
- 157. RAYNAUDS PHENOMENON
- 158. 2. NAILABNORMALITIES Abnormal nails Conditions Nail stripes Chronic constrictive pericarditis Dysplastic nails Ellis-van Creveld syndrome Plummer nails Hyperthyroidism Square/broad nails Acromegaly, cretin Koilonychias Iron deficiency anemia Splinter hemorrhage Infective endocarditis Clubbing Cyanotic congenital heart disease infective endocarditis, myxoid tumor
- 161. SPLINTER HEMORRHAGE
- 162. CLUBBING
- 164. 3. FOOT ABNORMALITIES: Foot abnormality Conditions Pes cavus Friedrichs ataxia, peroneal muscular atrophy Cardiomyopathy Pes planus Marfans syndrome AR MR Rocker bottom foot Edwards syndrome ASD VASD PDA Bow legs Achondroplasia OI Rickets osteomalacia Sabre tibia- congenital syphilis Knock knees Ellis-van Creveld and Laurence- Moon-Biedl syndromes
- 166. 4. JOINT ABNORMALITIES Joint abnormalities Conditions/ CV abnormality Migrating polyarthritis Rheumatic fever Jaccods arthritis Post-streptococcal reactive artritis Rheumatoid arthritis Pericarditis, Constrictive pericarditis, AR, MR, Conduction defects Gouty arthritis CAD, conduction abnormalities Hyperextensibity of joints Ehler – Danlos syndrome
- 168. GOUTY ARTHRITIS
- 170. PERIPHERAL EDEMA:
- 171. REFERENCES: 1. Harrisons principle of Internal Medicine 20th edition 2. Diagnosis of Cardiovascular diseases Jonathan Abrahams 3. Clinical examination in cardiology Vijay Raghav Rao
- 172. THANK YOU..