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Is there a murmur? Cardiomegaly with cardiac murmurs suggests valvular disease, but it also suggests congestive heart failure and advanced ... DIAGNOSTIC WORKUP
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Is it acute or chronic? An acute cardiac arrhythmia should make one consider a myocardial infarction first.
Is the heart rate slow, ... DIAGNOSTIC WORKUP
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Could the murmur be extracardiac in origin? Extracardiac murmurs include the pericardial friction rub and cardiorespiratory murmurs.
Is the murmur continuous? A ... DIAGNOSTIC WORKUP
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Cardiomegaly is defined as enlargement of the heart above the normal size. When looking at a chest X-ray, one must be sure that an anterior-posterior view is being used, because the heart may... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Cardiac auscultation should be performed in a systematic manner. Normal heart sounds (S1, S2) should be identified, and the precordium should be examined for gallops (S3... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The patient should be asked to describe the heart rhythm and to demonstrate it by either saying or tapping the speed and rhythm of the sensation. Additionally, teaching the patient to measure his or her pulse during the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Abnormal heart sounds are common in pediatric patients and usually benign. Approximately 50% of children will have an innocent murmur at some time, compared to a 1% incidence of congenital heart disease (nearly all of which present... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Heart failure exists when adequate cardiac output cannot be maintained either at rest or with activity. It can be either acute, chronic, or an acute decompensation of the chronic state, and represents a wide range of anatomic... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... If an x-ray film demonstrates cardiomegaly, the physician must find out what is causing this condition ( Table 13 ). You have already listened to the patient and he or she does not
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... With few exceptions, the etiologies of cardiac arrhythmias like those of bradycardia can best be recalled using the mnemonic VINDICATE. The exceptions are from one pathophysiologic
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... Left Heart Failure
Hypertensive heart disease
Coronary artery disease
Left ventricular diastolic dysfunction
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... Systolic
Early systolic
Physiologic (innocent)
Small ventricular septal defect
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... Arrhythmia (with or without digitalis intoxication)
Tachyarrhythmia
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... Signs and Symptoms Left-sided: dyspnea, orthopnea, crackles, wheezing, hypoxia, respiratory acidosis, cough, cyanosis, palpitations, arrhythmias, elevated blood pressure, pulsus alternans; right-sided: dependent... Treatment (Tx) ... Pictures
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... Acute rheumatic fever is a systemic inflammatory disease of childhood, in many cases recurrent, that follows a group A beta-hemolytic streptococcal infection. Rheumatic heart disease refers to the cardiac manifestations of rheumatic... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... In valvular heart disease, three types of mechanical disruption can occur: stenosis, or narrowing, of the valve opening; incomplete closure of the valve; or prolapse of the valve. They can result from such disorders as... Treatment ... Special considerations ... Pictures
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... Signs and Symptoms Loss of consciousness, absent pulse, apnea, anuria, cool extremities
Treatment (Tx) CPR, fluids, epinephrine, vasopressin, oxygen, mechanical ventilation,
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... In cardiac arrhythmias (sometimes called cardiac dysrhythmias), abnormal electrical conduction or automaticity changes heart rate and rhythm. (See Normal cardiac conduction, page 1126.)... Causes ... Signs and symptoms ... Diagnosis ... Special considerations ... Pictures
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... In cardiac tamponade, a rapid, unchecked rise in intrapericardial pressure impairs diastolic filling of the heart. The rise in pressure usually results from blood or fluid accumulation in the... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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Cardiomegaly
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... John Coe and Ron Sand
Cardiomegaly is a common, nonspecific finding that can be detected by physical examination, electrocardiogram (ECG), chest radiograph,... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Anthony F. Jerant
Congestive heart failure (CHF) is the most frequent reason for hospitalization among older adults in the United States. Nearly one-third of a national cohort of... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Heart Murmur, Diastolic
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... David E. Anisman and Gerald F. Farnell
A diastolic murmur is a finding that provides a clue to an underlying disease process. Unlike their systolic counterparts (Chapter 7.7), diastolic murmurs almost... Approach ... History ... Physical examination (PE) ... Testing ... Diagnostic assessment ... Pictures
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Heart Murmur, Systolic
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Dale Bishop
Systolic murmurs can herald significant clinical deterioration and sudden death, or they can represent stable or clinically insignificant conditions. Although... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Differential Overview
❑ Congestive heart failure
❑ Hypertensive left ventricular hypertrophy
❑ Anterior myocardial ischemia ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Phenomena
❑ S4 gallop
❑ Midsystolic click
❑ S3 ... Diagnostic Approach ... Clinical Findings
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... A syndrome characterized by myocardial dysfunction, heart failure leads to impaired pump performance (reduced cardiac output) or to frank heart failure and abnormal circulatory congestion. Congestion of... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Often recurrent, acute rheumatic fever is a systemic inflammatory disease of childhood that follows a group A beta-hemolytic streptococcal infection. Rheumatic heart disease refers to the cardiac manifestations of... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... In valvular heart disease, three types of mechanical disruption can occur: stenosis, or narrowing, of the valve opening; incomplete closure of the valve; or prolapse of the valve. They can result from such disorders... Treatment ... Special considerations ... Pictures
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... Abnormal electrical conduction or automaticity changes heart rate and rhythm in cardiac arrhythmias, also called cardiac dysrhythmias. (See Types of cardiac arrhythmias.... Causes ... Special considerations ... Pictures
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... With cardiac tamponade, a rapid, unchecked rise in intrapericardial pressure impairs diastolic filling of the heart. The rise in pressure usually results from blood or fluid accumulation in the pericardial sac. ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Normal murmursare due to turbulence of normal blood flow. A normal murmur does not result insymptoms. Cardiovascular exam, chest radiograph, and ECG are normal.... Principal Causes of Heart Murmurs (Asymptomatic) ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Clinicalsyndrome resulting from inability of myocardium to meet metabolicdemands of body. Combination of tachypnea, tachycardia,cardiomegaly, and hepatomegaly is cardiac failure until... Principal Causes of Cardiac Failure ... Clinical Features and Diagnosis ... Diagnostic Approach ... Table 7.1. Diagnostic Classification of Common Causes of CardiacFailure ... References
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...
If an x-ray film demonstrates cardiomegaly, the physician must find out
what is causing this condition (Table 13). You have already
listened to the patient and he or she does not have a murmur. This seems to
exclude... Pictures
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...
With few exceptions, the etiologies of cardiac arrhythmias like those
of bradycardia can best be recalled using the mnemonic VINDICATE. The
exceptions are from one pathophysiologic cause: ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
