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45-year-old diabetic who has developed right calf pain

History

A 45-year-old diabetic woman, two packs a day smoker, who has developed right calf pain with exertion.

Physical Exam

High blood pressure (150/95). Pulse rate 80. No pulse in right foot. Marked increase in chest diameter.

Exam

Use the 'auscultation' link above to virtually listen to this patient's heart and carotid sounds.



Auscultation Tips

Significant independent predictors of the presence of a confirmed cardiac lesion:

  • A loud murmur of intensity 3 or greater.
  • Best heard at the pulmonic location (2LICS).
  • Harsh sound.
  • Pansystolic murmur.
  • Systolic click.
  • Abnormal second heart sound - fixed splitting during respiration.

45-year-old diabetic who has developed right calf pain

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