Ebsteins anomaly of the tricuspid valve physical examination: Difference between revisions

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==Overview==
==Overview==
Ebstein's anomaly is characterized by [[tricuspid regurgitation]] and variable degrees a [[cyanosis]] depending upon the magnitude of [[right to left shunting]] and elevation of the [[jugular venous pressure]] is often present.
Ebstein's anomaly is characterized by [[tricuspid regurgitation]] and variable degrees a [[cyanosis]] depending upon the magnitude of [[right to left shunting]] and elevation of the [[jugular venous pressure]] is often present. A [[palpable]] prominent diffuse [[apical impulse]] may be felt. A [[holosystolic murmur]] from [[tricuspid regurgitation]], heard best along the left lower [[sternal]] border that increases with [[inspiration]] as well as a mid-[[diastolic murmur]] due to the high [[diastolic]] flow volume across the [[tricuspid valve]].
==Physical Examination==
==Physical Examination==



Latest revision as of 17:51, 12 February 2020

Ebsteins anomaly of the tricuspid valve Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] and Claudia P. Hochberg, M.D. [2]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]; Priyamvada Singh, MBBS [4] Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]

Overview

Ebstein's anomaly is characterized by tricuspid regurgitation and variable degrees a cyanosis depending upon the magnitude of right to left shunting and elevation of the jugular venous pressure is often present. A palpable prominent diffuse apical impulse may be felt. A holosystolic murmur from tricuspid regurgitation, heard best along the left lower sternal border that increases with inspiration as well as a mid-diastolic murmur due to the high diastolic flow volume across the tricuspid valve.

Physical Examination

Appearance

Patients may have a bluish coloration of their face depending on the degree of cyanosis and right to left shunting.

Vitals

The pulse may be weak due to right sided heart failure.

Skin

Skin examination is usually normal in patients with ebstein's anomaly.

Neck

Tricuspid regurgitation and increased right atrial pressure may cause an increase in jugular venous pressure. Prominent "a" wave in the distended jugular veins can be seen in these patients. In cases of severe tricuspid regurgitation, a prominent "v" wave may be seen.

Heart

Inspection

Palpation

Auscultation

  • Click sound may be heard due to abnormal movement of the anterior leaflet.

Lung

Abdomen

Back

  • Back examination is usually normal in patients with ebstein's anomaly.

Genitourinary

Neuromuscular

Extremities


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