Cardiovascular Medicine Book

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Hypertension Evaluation Exam

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  1. Goals
    1. Identify end organ damage
    2. Identify signs secondary Hypertension
    3. Identify reversible exacerbating factors
    4. Document progression
  2. Vitals
    1. BP Examination
    2. Pulse
    3. Assess for Obesity
      1. Weight and Height
      2. Ideal body weight or BMI
      3. Waist Circumference (assess for Metabolic Syndrome)
  3. Retinal Exam
    1. SEE Funduscopic Changes in Hypertension
  4. Neck Exam
    1. Thyroid exam
    2. Carotid Bruits
    3. Neck vein exam
  5. Chest exam
    1. Congestive Heart Failure signs
    2. Palpable intercostal pulses
  6. Cardiovascular Exam
    1. S4 Gallop rhythm (decreased LV compliance)
    2. Tachycardia
    3. Accentuated S2 Heart Sound
    4. Aortic Insufficiency murmur
    5. Abnormal EKG or Echocardiogram
    6. Prior Angiography results
  7. Abdominal Exam
    1. Abdominal bruit
    2. Abdominal Aortic Aneurysm
    3. Enlarged or tender kidneys (CVA pain)
  8. Genitourinary Exam
    1. Abnormal Sexual Development
    2. Enlarged prostate
  9. Peripheral Vascular Disease
    1. Femoral bruits
    2. Symmetrical pulses
    3. Lower extremity shin Hair Loss
  10. Neurologic
    1. Peripheral Neuropathy
  11. Skin Exam
    1. Stigmata of Cirrhosis
    2. Neurofibromata
    3. Chloasma
    4. Signs of Cushing's Disease
      1. Striae
      2. Acne Vulgaris
      3. Hirsutism

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