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Patient Presentations Related to the Circulatory and Hematologic Systems
Patient presentations span all ages and gender identities, reflecting patients from diverse backgrounds, cultures, and abilities and their reasons for presenting to osteopathic physicians in varied clinical settings.
| 8.1 Cardiovascular Chest Pain | |
| 8.2 Palpitations and Rhythm Disturbances | |
| 8.3 Edema and Swelling | |
| 8.4 Masses and Lymphadenopathy | |
| 8.5 Extremity Pain and Claudication | |
| 8.6 Shortness of Breath/Dyspnea and Orthopnea | |
| 8.7 Bruising, Bleeding, and Clotting Disturbances | |
| 8.8 Circulatory Collapse and Shock | |
| 8.9 Blood Pressure Evaluation | |
| 8.10 Chest Trauma | |
| 8.11 Blood Dyscrasias | |
| 8.12 Physical Exam Findings Related to the Circulatory and Hematologic Systems | |
| 8.13 Laboratory and Diagnostic Testing Related to the Circulatory and Hematologic Systems |
Clinical presentations in this category may include, but are not limited to, the following conditions or situations prompting patients to present for osteopathic medical care:
| Anemias | anemia of chronic disease • aplastic anemia • folate deficiency • hemolytic anemia • iron deficiency • sickle cell disease • thalassemia • vitamin B12 deficiency |
| Arrhythmias | atrial fibrillation • atrial flutter • heart block • long QT syndrome • premature atrial/ventricular contractions • sick sinus syndrome • sinus bradycardia • supraventricular tachycardia • ventricular fibrillation • ventricular tachycardia |
| Blood pressure disorders | hypertension • hypotension • near-syncope • pulmonary hypertension |
| Cardiac disorders | angina pectoris • cardiac arrest • cardiac tamponade • cardiomyopathy • heart failure • myocardial infarction |
| Chest injury | blunt trauma • cardiac contusion • penetrating trauma |
| Coagulation disorders | disseminated intravascular coagulopathy • factor V Leiden mutation • hemophilia • von Willebrand disease |
| Congenital cardiovascular disorders | arteriovenous malformation • atrial septal defect • bicuspid aortic valve • coarctation of the aorta • patent ductus arteriosus • patent foramen ovale • pulmonary valve stenosis • tetralogy of Fallot • transposition of the great arteries • ventricular septal defect |
| Hematologic disorders | amyloidosis • eosinophilia • hemochromatosis • hemolytic uremic syndrome • HIV infection/AIDS • malaria • polycythemia • sepsis • thrombocytopenia • thrombocytosis |
| Hematologic malignancies | cancer metastasis • leukemia • lymphoma • multiple myeloma |
| Inflammatory/infectious cardiovascular disorders | aortitis • endocarditis • myocarditis • pericarditis • vasculitis |
| Lymphatic disorders | lymphangioma • lymphangitis • lymphatic obstruction • lymphedema |
| Shock | cardiogenic • distributive • hypovolemic • mixed/unknown • obstructive • undifferentiated |
| Valvular heart disorders | aortic regurgitation • aortic stenosis • mitral regurgitation • mitral stenosis • mitral valve prolapse |
| Vascular disorders | aortic aneurysm and dissection • arteriosclerosis • arteritis • chronic venous insufficiency • coronary artery disease • deep vein thrombosis • hemangioma • IgA vasculitis • Kawasaki disease • mesenteric ischemia • pulmonary embolism • peripheral vascular disease • Raynaud syndrome • vasculitis • venous stasis/insufficiency |
CONSTITUTIONAL SIGNS AND SYMPTOMS
- anorexia
- chills
- fatigue
- fever
- generalized weakness
- jaundice
- malaise
- night sweats
- unintentional weight loss
PHYSICAL EXAMINATION FINDINGS AND EVALUATION
- arterial pulse evaluation
- blood pressure measurement
- calf tenderness, swelling
- cardiac murmur
- cardiac rub
- cardiac thrill
- Chapman reflexes
- clubbing
- cyanosis
- delayed/unequal pulses
- edema
- heart sounds
- hepatomegaly
- Janeway lesions
- jugular venous pressure
- jugular venous wave forms
- lymphadenopathy
- pallor
- parasternal heave
- petechiae
- point of maximal impulse
- pulsus alternans
- pulsus parvus
- purpura
- splenomegaly
- splinter hemorrhages
- tender points
- vascular bruits
- viscerosomatic/
somatovisceral reflexes - waterhammer pulse
LABORATORY AND DIAGNOSTIC TESTING
- angiography
- B-type natriuretic peptide level
- blood cultures
- blood typing
- cardiac enzyme levels
- CD4 count
- coagulation factor assays
- coagulation profile
- complete blood count
- C-reactive protein level
- CT scanning
- D-dimer level
- ECG, 12-lead and rhythm strips
- echocardiography
- erythrocyte sedimentation rate
- genetic testing
- hemoglobin electrophoresis
- high-sensitivity troponin levels
- HIV testing (antibody, antigen, viral load)
- iron studies
- lipid profile
- MRI
- nuclear medicine imaging
- peripheral blood smear
- radiography
- reticulocyte count
- serum protein electrophoresis
- stress testing
- tilt-table test
- ultrasonography