Physical Finding |
Associated cardiac condition(s) |
Head & Neck |
|
De Musset sign (head bobbing) |
Aortic regurgitation |
Hoarseness |
Pericardial effusion, thoracic aneurysm |
Hiccups |
Pericardial effusion (phrenic nerve stimulation) |
Eyes |
|
Dislocated lens / ectopialentis (Marfan’s syndrome) |
Aortic regurgitation, mitral valve prolapse |
Blue Sclera, brittle bones (Osteogenesisimperfecta) |
Mitral valve prolapse, aortic dilation/regurgitation and dissection |
Bilateral forward displacement of eyeballs (Graves' ophthalmopathy) |
Tachycardia, atrial fibrillation, high output heart failure |
Systolic pulsation |
Severe tricuspid regurgitation |
Chest |
|
Pectusexcavatum, straight/ flat thoracic spine (Straight-back syndrome, ankylosing spondylitis) |
Mitral valve prolapse syndrome, aortic regurgitation |
Hands & Legs |
|
Unilateral digital clubbing |
Aortic aneurysm (interferes with blood supply to one arm), brachial arteriovenous fistula, arterial graft sepsis, & hemiplegic stroke |
Bilateral digital clubbing |
Cyanotic congenital heart disease, neoplastic & suppurative intrathoracic disease, diffuse pulmonary disease, infective endocarditis, inflammatory bowel disease, celiac disease, cirrhosis, thyroid acropachy (extreme autoimmune thyroid disease) |
Ulnar deviation, "swan neck" (rheumatoid arthritis) |
Aortic regurgitation, mitral regurgitation, pericarditis, cardiomyopathy |
Arachnodactyly "spider fingers" long and slender digits (Marfan’s syndrome) |
Aortic regurgitation, mitral valve prolapse |
Xanthoma |
Hypercholesterolemia |
Systolic blush & diastolic blanch when upward traction on the fingernail (Quincke's pulse) |
Aortic regurgitation |
Thumb with extra phalanx (Holt-Oram syndrome) |
Atrial septal defect |
Petechiae |
Infective endocarditis, trauma |
Painless hemorrhagic lesions on palms or soles (Janeway lesions) |
Infective endocarditis |
Small tender erythematous skin lesions on pads of the fingers, toes, palms or soles (Osler nodes) |
Infective endocarditis |
Triphasic (white, blue, red) change of finger color in cool temperatures or emotional stress |
Raynaud’s phenomenon |
Bilateral peripheral edema |
Excess extracellular fluid (5 liters or more): heart failure, constrictive pericarditis |
Unilateral peripheral edema |
Venous obstruction/damage/removal, hemiplegia (on paralyzed side) |