The record
The patient is icteric, pigmented. He has clubbing, leuconychia, palmar erythema and dupuytren's contracture and several spider naevi.There is or there is no flapping tremor of the hands. There is scratch marks on the forearms and back, and there is purpura. There is gynaecomastia, scanty hair and his testes are small.
also he has generalized swelling of the abdomen and the umblicus is everted there is distended abdominal wall veins in which the flow is away from, the umbilicus.The liver is palpable at .. cm below the right costal margin with a span of about cm indicating hepatmegaly and 3 cm splenomegaly. The flanks are dull to percussion but the center is resonant. The dullness is shifting and fluid thrill is present or not present so he has ascites. ankle edema is also present .
The diagnosis is likely to be cirrhosis of the liver with portal hypertension.
Thursday, August 23, 2012
Sunday, August 5, 2012
Systolic Murmurs
1- Pansystolic murmur : extends throughout systole, begining with the first heart sounds, going right up to the second heart sound.
Occur when a ventricle leaks into a lower pressure chamber or vessel.
Causes include
Mitral Regurgitation , Tricuspid regurgitation and VSD.
Record Description of Mitral Regurgitation
The pulse is regular at 80 beats per min. The venous pressure is not raised and there is no Ankle edema. The apex beat is thrusting ( volume overload) in the sixth inetrcostal space in the anterior axillary line, and there is or there is no thrill.
There is or there is no left parasternal heave. The first heart sound is soft, and there is a third heart sound. There is loud pansystolic murmur at the apex, radiating to the axilla.
The Diagnsois is Mitral Regurgitation with signs of of pulmonary hypertension.
2- Midsystolic Murmur
Like Aortic stenosis, pulmonary stenosis or hypertrophic cardiomyopathy or pulmonary flow murmur of ASD.
Caused by Trubulent flow through the aortic or pulmonary valve orifices or by greatly increased flow through a normal sized orifice or outflow tract.
Record Desciprtion of Aortic stensois
The pulse is regular at 70 beats per minutes, of small volume and slow rising. The venous pressure is not raised. The apex beat is palpable 1 cm to the left of the midclavicular line in the fifth intercostal as a forceful sustained heave. There is a systolic thrill or there is not thrill palpable over the aortic area radiating into the neck, and the aortic secod sound is soft.
The diagnosis is aortic stenosis.
Occur when a ventricle leaks into a lower pressure chamber or vessel.
Causes include
Mitral Regurgitation , Tricuspid regurgitation and VSD.
Record Description of Mitral Regurgitation
The pulse is regular at 80 beats per min. The venous pressure is not raised and there is no Ankle edema. The apex beat is thrusting ( volume overload) in the sixth inetrcostal space in the anterior axillary line, and there is or there is no thrill.
There is or there is no left parasternal heave. The first heart sound is soft, and there is a third heart sound. There is loud pansystolic murmur at the apex, radiating to the axilla.
The Diagnsois is Mitral Regurgitation with signs of of pulmonary hypertension.
2- Midsystolic Murmur
Like Aortic stenosis, pulmonary stenosis or hypertrophic cardiomyopathy or pulmonary flow murmur of ASD.
Caused by Trubulent flow through the aortic or pulmonary valve orifices or by greatly increased flow through a normal sized orifice or outflow tract.
Record Desciprtion of Aortic stensois
The pulse is regular at 70 beats per minutes, of small volume and slow rising. The venous pressure is not raised. The apex beat is palpable 1 cm to the left of the midclavicular line in the fifth intercostal as a forceful sustained heave. There is a systolic thrill or there is not thrill palpable over the aortic area radiating into the neck, and the aortic secod sound is soft.
The diagnosis is aortic stenosis.
Subscribe to:
Posts (Atom)