Pacemaker syndrome physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

• Diaphoresis
• Apprehension

• Tachycardia
• Irreregular peripheral pulse

• Orthostatic hypotension
• Hypovolemic shock
• Fluctuating blood pressure and pulse pressure

• Tachypnea

• Neck vein distension (elevated JVP)
• Cannon waves in the neck veins

Crackles may be heard at the bases of the lungs

Pulmonary rales

• S3 gallop

• Regurgitant murmurs and variability of heart sounds may be heard on auscultation.

• Abdominal distension (ascites) may be present in severe cases

• Tenderness may be present at the right upper quadrant (RUQ)

• Pulsatile liver may be palpated

• Edema may be present
• cool extremities

• Confusion and dizziness may be observed
• Mental status may be altered

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