By Franklin B. Saksena
Chapter 1 normal Observations (pages 1–8):
Chapter 2 Face (pages 9–39):
Chapter three Ear (pages 40–41):
Chapter four Mouth and nostril (pages 42–47):
Chapter five Neck (pages 48–49):
Chapter 6 Hand (pages 50–68):
Chapter 7 higher Extremity (pages 69–72):
Chapter eight Thorax again (pages 73–82):
Chapter nine stomach (pages 83–87):
Chapter 10 reduce Extremity (pages 88–97):
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Extra info for Color Atlas of Local and Systemic Signs of Cardiovascular Disease
It is associated with mitral valve prolapse, hypertension, peripheral vascular disease, and premature CAD . The latter being a common cause of early death . Neck 49 Figure 93 Pseudoxanthoma elasticum: yellow papules (arrows) are present over the entire neck (mitral valve prolapse, CAD). (Reprinted with permission from Elsevier. Copyright 1995) Figure 94 Pseudoxanthoma elasticum. The skin folds over the axilla are lax. (Reprinted with permission from Elsevier. Copyright 1995) 6 CHAPTER 6 Hand Examination of the hands provides a most useful mirror of systemic disease .
This sign is not to be confused with the tracheal tug in systole due to an aortic aneurysm. Webbing of the neck is seen in (a) genetic disorders: Turner syndrome (Figure 11) , Down syndrome, or Noonan’s syndrome (Figure 20); (b) congenital heart disease: hypoplastic left ventricle and secundum ASD ; and (c) chromosomal abnormalities [135–139]. Pseudoxanthoma elasticum in the neck consists of a network of closely grouped yellow papules (plucked chicken skin appearance) (Figure 93). The skin is lax and hangs in folds.
7 years. The results below showed only a modest sensitivity and speciﬁcity for detecting CAD if a positive ear crease sign was present. 48 (Unpublished data of Saksena & Enas). 40 Figure 80 Coronary artery disease. Ear-crease sign in a patient with three-vessel coronary artery disease (upper photo). Hairy ear sign is also seen in coronary artery disease (lower photo). Ear 41 Figure 81 Ochronosis: there is a dark brown-pigmented area involving the ear (aortic or mitral valvular disease). A diagonal ear-crease sign is also seen.