Physical examination helps refine the differential diagnosis. While chest pain may be the initial complaint, often the whole body needs to be examined. Example components of the physical exam may include:
Vital signs
- Blood pressure (BP), pulse rate (PR), respiratory rate (RR), temperature, and
- Oxygen saturation (O2 sat)
Head and neck
- Looking for neck vein distension or bulging
- Listening over the carotid arteries for bruits (abnormal sounds) ormurmurs
Chest wall
- Palpate for rib or muscle tenderness
- Look for rashes
Lungs
- Listen for abnormal lung sounds or decreased air entry
Heart
- Listen for abnormal heart sounds, murmurs or rubs (a friction sound made by two rough surfaces rubbing against each other, which may be seen with inflammation of the heart lining, called pericarditis)
- Listen for muffled heart tones
Abdomen
- Palpate for tenderness or masses
- Listen for bruits over the aorta
Extremities
- Feel for pulses
