Dilated cardiomyopathy physical examination

Overview

Patients with dilated cardiomyopathy (DCM) usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

Physical Examination

Appearance of the Patient

• Patients with DCM usually appear [general appearance].

Vital Signs

• High-grade / low-grade fever
• Tachycardia with regular or irregular pulse (in case of atrial fibrillation)
• Tachypnea
• Kussmal respirations may be present in _____ (advanced disease state)
• Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
• High/low blood pressure with normal pulse pressure

Skin

• Cyanosis
• Pallor in case of heart failure.

HEENT

• HEENT examination of patients with DCM is usually normal

Neck

• Jugular venous distension

Lungs

• Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
• Vesicular breath sounds OR distant breath sounds
• Normal/reduced tactile fremitus

Heart

• Lateral displacement of the point of maximal impulse (PMI)
• Right ventricular heave
• S₂ at the base (paradoxical splitting, prominent P₂)
• S₃
• S₄
• S3 Gallops
• Atrial fibrillation may be present

Abdomen

• Hepatomegaly in heart failure

Back

• Back examination of patients with DCM is usually normal

Genitourinary

• Genitourinary examination of patients with 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 failure

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