Department of Internal Medicine, University of California, Davis, 4860 Y Street Suite 0100, Sacramento, CA 95817, USA.
Department of Internal Medicine, University of California, Davis, 4150 V Street Suite 3100 PSSB, Sacramento, CA 95817, USA.
Med Clin North Am. 2022 May;106(3):447-458. doi: 10.1016/j.mcna.2021.12.002. Epub 2022 Apr 4.
Heart disease is the leading cause of death in the United States with an estimated 6 million adults living with heart failure. In patients with heart failure, the physical examination can provide important prognostic information and is also used to guide both diagnosis and management, including determining the need for inpatient versus outpatient management. Presenting symptoms include dyspnea, peripheral edema, orthopnea, paroxysmal nocturnal dyspnea, and bendopnea. In patients with suspected heart failure, a "head-to-toe" physical examination approach is recommended with the addition of special maneuvers such as the measurement of jugular venous pressure, valsalva maneuver, and hepatojugular reflux as needed.
心脏病是美国的主要死因，据估计，有 600 万成年人患有心力衰竭。在心力衰竭患者中，体格检查可以提供重要的预后信息，也用于指导诊断和治疗，包括确定需要住院治疗还是门诊治疗。主要症状包括呼吸困难、外周水肿、端坐呼吸、夜间阵发性呼吸困难和弯腰呼吸困难。对于疑似心力衰竭的患者，建议采用“从头到脚”的体格检查方法，并根据需要增加特殊检查，如颈静脉压测量、瓦尔萨尔瓦动作和肝颈静脉反流。
