Enlargement of the Heart (Cardiomegaly): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

• General physical examination – including blood pressure, pulse, body weight, height; further:
  • Inspection (viewing) due topossible:
    • Neck vein congestion?
    • Edema (praetibial edema?/water retention in the area of the lower leg/before the tibia, ankle; in supine patients: presacral/before the sacrum).
    • Central cyanosis? [bluish discoloration of skin and central mucous membranes, e.g., tongue]
  • Auscultation (listening) of the heart (auscultation findings: possible flow sounds over the outflow tract of the left ventricle/left ventricle; third heart sound/if present: Indication of heart failure/heart failure).
  • Auscultation of the lungs [rales (RGs)?
  • Examination of the abdomen (belly) [hepatomegaly? (congested liver); splenomegaly? (secondary to portal hypertension/pulmonary hypertension)]
    • Percussion (palpation) of the abdomen.
      • Meteorism (flatulence): hypersonoric tapping sound.
      • Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?
      • Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?).
• 6-Minute Walk Test – standardized procedure for objective assessment, determination of severity, and progression of exercise limitation attributable to cardiopulmonary causes (at baseline and during the course of the disease).

Square brackets [ ] are used to indicate possible pathological (pathological) physical findings.