The Rational Clinical Examination
David L. Simel, Drummond Rennie
Murmur, Diastolic
Niteesh K. Choudhry, Edward E. Etchells
Sections:
Clinical Scenario, Why Is the Clinical Examination Important in Evaluating for Aortic Regurgitation?, Methods, The Bottom Line for Aortic Regurgitation, The Bottom Line for Diastolic Murmurs in Patients With Renal Failure, Clinical Scenario—Resolution, References
Topics Discussed:
aortic valve insufficiency, diastolic murmur
Excerpt:
"You are asked to see a 59-year-old woman with liver cirrhosis
and esophageal varices. When she was checked into the clinic, she
had a pulse pressure of 70 mm Hg. Because of the wide pulse pressure,
you wonder if she has aortic regurgitation (AR). You conduct a complete
physical examination and hear no early-diastolic murmur in the third
or fourth intercostal spaces at the left sternal border. You suspect
that the wide pulse pressure is a peripheral hemodynamic consequence
of cirrhosis, not AR. Do you need an echocardiogram to confirm your
clinical impression that she does not have AR?..."
Log in to read the full chapter:
Get full access to JAMAevidence two ways:
Subscribe to JAMAevidence
JAMAevidence is a subscription-
based website dedicated to the learning, teaching, and practicing of evidence-based medicine.
Pay Per View
Timed access to all of JAMAevidence
24 hours for $29.95
48 hours for $49.95