床边体检用于诊断大动脉狭窄症:系统性审查和元分析
Richard A Shellenberger1, Stephanie Crass1, Justin Jevicks1
1Department of Internal Medicine, Trinity Health Ann Arbor Hospital, Reichert Health Center, Ypsilanti, Michigan, USA.
CJC open
|June 28, 2023
概括
身体检查结果,如减弱的第二心声和延迟的动脉中风,可以帮助诊断中度大动脉狭窄 (AS). 无辐射声的存在有效排除了这种情况.
科学领域:
- 心脏病学 心脏病学
- 诊断的准确性 诊断的准确性
- 身体检查 身体检查
背景情况:
- 退行性大动脉狭窄症 (AS) 在症状出现之前经常出现严重阻塞.
- 评估身体检查的准确性对于诊断中度或重度AS至关重要.
研究的目的:
- 评估体检发现的诊断准确性,以确定至少中度严重的大动脉狭窄 (AS).
主要方法:
- 进行了观察性研究的系统审查和元分析.
- 在多个数据库 (PubMed,MEDLINE,Cochrane等) 进行了搜索. 从开始到2021年12月.
- 包括在左心导管或心声回声仪之前进行心血管物理检查的研究.
主要成果:
- 减弱的第二次心声 (LR=10.87) 和延迟的动脉上风 (LR=9.04) 是中度至重度AS的迹象.
- 缺少向部辐射的缩声 (LR=0.11),有效地排除了中度至重度的AS.
结论:
- 低质量的证据表明,减弱的第二心声和延迟的动脉中风在诊断中度至严重的AS时具有中度的准确性.
- 没有辐射声是准确的排除中度至重度的AS.
更多相关视频
相关概念视频
Aneurysm II: Clinical Manifestations and Diagnostic Studies
11
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
11
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
19
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
19
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
16
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
16
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
33
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
33
Assessment of the Cardiovascular System II: Inspection
294
Inspection is the initial step in assessing the cardiovascular system. It involves a detailed visual examination that provides crucial information about a patient's circulatory and cardiac health. This systematic process, conducted from head to toe, helps identify signs of cardiovascular conditions by observing physical appearance, skin and mucous membranes, jugular and carotid pulsations, chest symmetry, and the condition of the extremities.
Head and Neck
Head and Neck
294
Assessment of blood pressure in brachial artery(one-step method)
647
This procedural guide systematically measures blood pressure using an oscillometric digital sphygmomanometer, emphasizing accuracy, patient safety, and comfort.
Prepare for the Procedure:
Prepare for the Procedure:
647


