Covered in this review are eponymic signs of inspection of the precordium
seen in patients with pericarditis.
A continuous murmur with thrill was heard across the precordium
. Examination of the foot revealed exposed medial malleolus with purulent discharge.
without visible or palpable pulsations, thrills, or lifts.
On auscultation of the precordium
, one finds soft first and second heart sounds and there may be an additional third heart sound.
Cardiovascular exam revealed normal peripheral pulses, a quiet precordium
with normal heart sounds, and no murmur.
Mild degrees of bradycardia, diastolic hypertension, a narrow pulse pressure and relatively quiet precordium
, and decreased intensity of the apical impulse are all characteristics .
The physical exam was notable for a right-sided point of maximal impulse (PMI), an active precordium
that appeared to extend to the subcostal area and an umbilical hernia.
I then tightly rolled a sheet of paper, one end of which I placed over the precordium
(chest) and my ear to the other.
According to Nuntnarumit et al; the Clinical hsPDA was defined as the presence of the ductal flow with predominant left to right shunt on color Doppler which measured at least 1.5mm on two- dimensional echocardiography plus at least two of the following signs, including heart murmur, persistent tachycardia (heart rate >160 beats/min), hyperactive precordium
, bounding pulse, pulse pressure >25 mmHg, hepatomegaly, pulmonary hemorrhage (defined as blood or blood-stained fluid aspirated from the endotracheal tube in association with a respiratory deterioration and radiographic evidence of pulmonary hemorrhage), increasing respiratory support by 20% increase in oxygen supplementation or in pressure support and chest radiographic evidence of cardiomegaly or pulmonary congestion.24
On auscultation, the lungs were clear, and a pansystolic murmur was heard over the right side of the precordium
. Chest X-ray and echocardiography revealed a dextrocardia and PDA measuring 3 mm [Figure 2].
Commotio cordis is defined as the "mechanical stimulation of the heart by non-penetrating, impulse-like impact to the precordium
that, through intrinsic cardiac mechanisms, gives rise to disturbances of cardiac rhythm of varying type, duration, and severity, including sudden cardiac death, in the absence of structural damage that would explain any observed effects" .