Heartburn physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Heartburn}} | {{Heartburn}} | ||
{{CMG}}; {{AE}} {{Jose}} {{AEL}} {{CZ}} | |||
==Overview== | |||
Patients with [[heartburn]] usually appear discomfortable, but the symptoms are commonly mild and frequent. | |||
Occasionally the patients may appear [[Ill feeling|ill]] due to the [[pain]] in a emergency department setting. Common physical examination may include [[hoarseness]] of voice, [[laryngitis]], [[otitis media]], and [[Wheeze|lung wheezes]]. | |||
==Physical Examination== | |||
===Gastroesophageal reflux disease=== | |||
====Appearance of the patient==== | |||
* Patients with [[heartburn]] usually appear uncomfortable due to the retrosternal [[pain]]. | |||
==== Vital signs ==== | |||
* [[Hypertension]] spicking specially in patients already with pre-existing hypertension, due to the pain.<ref name="pmid28961574">{{cite journal| author=Li ZT, Ji F, Han XW, Wang L, Yue YQ, Wang ZG| title=The Role of Gastroesophageal Reflux in Provoking High Blood Pressure Episodes in Patients With Hypertension. | journal=J Clin Gastroenterol | year= 2017 | volume= | issue= | pages= | pmid=28961574 | doi=10.1097/MCG.0000000000000933 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28961574 }}</ref> | |||
====HEENT==== | |||
* [[Hoarseness]] of voice | |||
* [[Laryngitis]] | |||
* [[Otitis media]] | |||
* [[Erosion (dental)|Dental erosions]] | |||
====Lungs==== | |||
* [[Wheeze|Wheezes]] | |||
* [[Bronchitis]]<ref name="pmid23452632">{{cite journal| author=Hom C, Vaezi MF| title=Extraesophageal manifestations of gastroesophageal reflux disease. | journal=Gastroenterol Clin North Am | year= 2013 | volume= 42 | issue= 1 | pages= 71-91 | pmid=23452632 | doi=10.1016/j.gtc.2012.11.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23452632 }}</ref> | |||
====Abdomen==== | |||
* [[Epigastric]] [[tenderness]], which may be severe and sometimes be mistaken with [[acute coronary syndrome]] or other causes of [[acute abdomen]]. | |||
===Scleroderma=== | |||
*[[CREST syndrome]] presents with [[calcinosis]], [[Raynaud's phenomenon]], [[esophageal dysmotility]], [[sclerodactyly]], and [[telangiectasia]].<ref name="pmid28613625">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=28613625 | doi= | pmc= | url= }} </ref> | |||
===Acute Coronary Syndromes=== | |||
In the evaluation of a patient presenting with ACS, [[hypotension]] (systolic blood pressure <100 mm Hg), [[tachycardia]] (pulse >100) and [[bradycardia]] (pulse <60 bpm) indicate that the patient is at higher risk. | |||
* Patients may present signs of [[cardiac failure]], such as a [[3rd heart sound]], a [[4th heart sound]] or a new/increased [[systolic murmur of mitral regurgitation]]. | |||
* The presence of a [[pericardial rub]] would suggest [[pericarditis]] instead of [[ACS]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category: | [[Category:General practice]] | ||
[[Category: | [[Category:Gastroenterology]] | ||
[[Category: | [[Category:Digestive disease symptoms]] | ||
Latest revision as of 19:53, 6 September 2020
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Heartburn Microchapters |
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Heartburn physical examination On the Web |
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American Roentgen Ray Society Images of Heartburn physical examination |
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Risk calculators and risk factors for Heartburn physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2] Ahmed Elsaiey, MBBCH [3] Cafer Zorkun, M.D., Ph.D. [4]
Overview
Patients with heartburn usually appear discomfortable, but the symptoms are commonly mild and frequent. Occasionally the patients may appear ill due to the pain in a emergency department setting. Common physical examination may include hoarseness of voice, laryngitis, otitis media, and lung wheezes.
Physical Examination
Gastroesophageal reflux disease
Appearance of the patient
Vital signs
- Hypertension spicking specially in patients already with pre-existing hypertension, due to the pain.[1]
HEENT
- Hoarseness of voice
- Laryngitis
- Otitis media
- Dental erosions
Lungs
Abdomen
- Epigastric tenderness, which may be severe and sometimes be mistaken with acute coronary syndrome or other causes of acute abdomen.
Scleroderma
- CREST syndrome presents with calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia.[3]
Acute Coronary Syndromes
In the evaluation of a patient presenting with ACS, hypotension (systolic blood pressure <100 mm Hg), tachycardia (pulse >100) and bradycardia (pulse <60 bpm) indicate that the patient is at higher risk.
- Patients may present signs of cardiac failure, such as a 3rd heart sound, a 4th heart sound or a new/increased systolic murmur of mitral regurgitation.
- The presence of a pericardial rub would suggest pericarditis instead of ACS.
References
- ↑ Li ZT, Ji F, Han XW, Wang L, Yue YQ, Wang ZG (2017). "The Role of Gastroesophageal Reflux in Provoking High Blood Pressure Episodes in Patients With Hypertension". J Clin Gastroenterol. doi:10.1097/MCG.0000000000000933. PMID 28961574.
- ↑ Hom C, Vaezi MF (2013). "Extraesophageal manifestations of gastroesophageal reflux disease". Gastroenterol Clin North Am. 42 (1): 71–91. doi:10.1016/j.gtc.2012.11.004. PMID 23452632.
- ↑ "StatPearls". 2020. PMID 28613625.