Department of Internal Medicine, UC Davis School of Medicine, 4150 V Street, Suite 2400, Sacramento, CA 95817, USA.
Department of Internal Medicine, UC Davis School of Medicine, 4150 V Street, Suite 2400, Sacramento, CA 95817, USA.
Med Clin North Am. 2022 May;106(3):545-555. doi: 10.1016/j.mcna.2021.12.011. Epub 2022 Apr 4.
Patients with valvular heart disease may present with or without symptoms. A thorough cardiac physical examination can identify patients who require further evaluation and management. Although the utility of different cardiac findings varies widely, diastolic murmurs indicate important underlying valvular pathology requiring further investigation, typically with echocardiography. The proper examination of patients with systolic murmurs, the most common murmurs in clinical practice, is fundamental to cost-effective care. We will review the key components of the cardiac examination and findings relevant to functional murmurs, aortic stenosis, mitral valve prolapse and regurgitation, tricuspid regurgitation, hypertrophic cardiomyopathy, aortic regurgitation, and mitral stenosis.
患有心脏瓣膜病的患者可能有症状或无症状。全面的心脏体格检查可以识别出需要进一步评估和管理的患者。尽管不同的心脏发现的用途差异很大，但舒张期杂音表明存在需要进一步检查的重要潜在瓣膜病理，通常需要进行超声心动图检查。收缩期杂音（临床上最常见的杂音）患者的适当检查对于具有成本效益的护理至关重要。我们将回顾心脏检查的关键组成部分以及与功能性杂音、主动脉瓣狭窄、二尖瓣脱垂和反流、三尖瓣反流、肥厚型心肌病、主动脉瓣反流和二尖瓣狭窄相关的发现。
