Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Other diagnostic factors

  • dyspnea
  • fatigue
  • weakness
  • orthopnea
  • paroxysmal nocturnal dyspnea
  • pallor
  • mottled extremities
  • rapid and faint peripheral pulse
  • jugular venous distension
  • basal lung crepitations
  • altered mental status
  • urine output <30 mL/hour
  • soft S1
  • soft or absent A2
  • collapsing (water hammer or Corrigan) pulse
  • cyanosis
  • tachypnea
  • displaced, hyperdynamic apical impulse
  • chest pain
  • pink frothy sputum
  • wheeze (cardiac asthma)
  • additional heart sounds
  • arrhythmias
  • ejection systolic flow murmur
  • Austin Flint murmur
  • systolic thrill
  • Hill sign
  • Bisferiens pulse
  • de Musset sign
  • Muller sign
  • Traube sign
  • Quincke sign
  • Duroziez sign
  • Mayen sign
  • Lighthouse sign
  • Becker sign
  • Landolfi sign
  • Rosenbach sign
  • Gerhardt sign
  • Lincoln sign
  • Sherman sign
  • palmar click
  • syncope

Risk factors

  • bicuspid aortic valve
  • rheumatic fever
  • endocarditis
  • Marfan syndrome and related connective tissue disease
  • systemic hypertension
  • aortitis
  • older age

Diagnostic investigations

1st investigations to order

  • ECG
  • CXR
  • echocardiogram
  • M-mode and 2-dimensional imaging
  • color flow Doppler
  • pulsed wave Doppler
  • continuous wave Doppler
Full details

Investigations to consider

  • radionuclide angiography
  • MRI
  • exercise stress testing
  • cardiac catheterization
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Sanjeev Wasson

Medical Director

Department of Cardiology

Skagit Valley Hospital

Mount Vernon

WA

Disclosures

SW declares that he has no competing interests.

Nishant Kalra

Associate Faculty Member

Department of Cardiology

University of Arizona

Tucson

AZ

Disclosures

NK declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Clinical Medicine

University of Missouri-Columbia

Chief

Cardiology Section

Harry S. Truman Veterans Hospital

Columbia

MO

Disclosures

KA declares that he has no competing interests.

Consultant Cardiologist and Honorary Senior Clinical Lecturer

Manchester Heart Centre

Central Manchester and Manchester Children's NHS Foundation Trust

Manchester

UK

Disclosures

RK declares that he has no competing interests.

Consultant Cardiac Surgeon

Department of Surgery

Royal Brompton Hospital

London

UK

Disclosures

JP declares that he has no competing interests.

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