Right heart failure physical examination

Physical exam should consist of a thorough cardiovascular exam, an abdominal exam, and examination of the extremities. Findings to be aware of are cyanosis, JVD, S2 and S3 heart sounds, ascites, hepatomegaly, and pedal edema.

• Cyanosis (bluish color to the skin)

• Elevated jugular venous pressure (swelling (distension) of the neck veins)
• Right sided S3
• Fixed split S2 in the presence of an atrial septal defect

• Ascites (abnormal fluid collection in the abdomen)
• Hepatomegaly (enlargement of the liver)

• Pedal edema (swelling of the ankles)

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