Bedside Cardiology by coll.

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Pectus carinatum 2. Pectus excavatum requiring surgery 3. 05 4. Wrist or thumb sign Minor Pectus excavatum Joint hypermobility Highly arched palate Facial appearance (dolichocepnaly, malar hypoplasia, down-slanting palpebral fissure, retroganthia). 5. Scoliosis > 20° or spondylosis 6. Reduced extension of elbow < 170° Enophthalmos 7. Pes planus 8. Protrusio acetabulae (radiological) (For skeletal system to be considered involved, at least 2 of the components comprising the major criterion or 1 component comprising the major criterion plus 2 of the minor criteria must be present) Ocular system 1.

Patient with regurgitant lesion feels the pounding sensation more in lying or left lateral decubitus. Palpitation and catecholamine excess: Exercised induced disproportionate rapid palpitation may be due to catecholamine induced idiopathic ventricular tachycardia, atrial fibrillation or supraventricular arrhythmia. Postexercise palpitation may occur due to vagal induced atrial fibrillation. Mild exertion or emotional stress can cause palpitation in young female patient due to hypersensitivity of beta-adrenergic stimulation.

Occasionally, there may be frank pulmonary edema. An infant with ASD is less symptomatic. This is because of two factors. Increased left atrial pressure as a reflection of increased LVEDP is vented through the septal defect. Secondly, L-R shunt here is not driven by systemic pressure. Tachypnea and Dyspnea Tachypnea is a rapid, shallow breathing without apparent distress. In a quiet child, rate is usually above 60/minute from birth to six weeks and above 40/ minute from 6 weeks to two years. It is a reflex-response mediated by J-receptors in the interstitial space, stimulated by interstitial edema.

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