Table 1: General inspection

Physical Finding Associated cardiac condition(s)
Peripheral cyanosis Heart failure, vasoconstriction
Central (circumoral) cyanosis Congenital heart disease, corpulmonale, right-to-left shunting (cardiac or extracardiac), inadequate pulmonary oxygenation of blood
Differential cyanosis (hands/fingers pink, feet/toes cyanotic) Patent ductusarteriosus with pulmonary hypertension & a reversed shunt, transposition of the great arteries, pulmonary hypertension, preductal narrowing of aorta
Orthopnea (unable to lie flat) - patient propped up with >=2 pillows to remain comfortable Congestive heart failure
Turners Syndrome (dwarfism especially a short stature girl with webbed neck) Aortic coarctation, bicuspid aortic valve
Marfan’s syndrome (arm span>body height) Aortic regurgitation, mitral valve prolapse
Downs syndrome Atrial septal defect, ventricular septal defect
Cafe-au-lait spots & mental retardation (Watson's syndrome) Pulmonary stenosis
Cheyne-Stokes respirations (oscillation of ventilation between apnea and hyperpnea) Congestive heart failure
Kaposi sarcoma, painful mucocutaneous ulcers, lipodystrophy (HIV patient) Pericarditis, myocarditis, cardiomyopathy, pulmonary hypertension, valvular disease, coronary artery disease
Low resting oxygen saturation (<93%) on a pulse oximeter on room air Hypoventilation, ventilation-perfusion mismatch, right-to-left shunt, diffusion limitation, reduced inspired oxygen tension.
Low oxygen saturation corrects with 100% oxygen Physiological shunting: hypoventilation, pulmonary edema, cardiogenic shock (anatomical shunts don’t correct)