CLINICAL-HYPERTENSION EXAMINATION

SUMMARY

1. General inspection - features of Cushing's, acromegaly.

2. Finger clubbing.

3. Pulse - radio-radial delay (subclavian artery stenosis); radio-femoral delay (aortic coarctation).

4. Measure BP from right and left arms.

5. Measure postural BP - wait 2 min after change of posture.

6. Examine JVP - raised due to heart failure.

7. Examine apex - heaving apex, displaced due to ventriculomegaly.

8. Auscultation - S3 gallop rhythm.

9. Ask to examine - fundus (hypertensive retinopathy), abdomen (renal artery stenosis, AAA, ballotable kidneys, ascites, tender & palpable liver).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].