What is the range of physical findings in acute coronary syndrome (ACS)?

Updated: Sep 30, 2020
  • Author: David L Coven, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Physical findings can range from normal to any of the following:

  • Hypotension: Indicates ventricular dysfunction due to myocardial ischemia, myocardial infarction (MI), or acute valvular dysfunction

  • Hypertension: May precipitate angina or reflect elevated catecholamine levels due to anxiety or to exogenous sympathomimetic stimulation

  • Diaphoresis

  • Pulmonary edema and other signs of left heart failure

  • Extracardiac vascular disease

  • Jugular venous distention

  • Cool, clammy skin and diaphoresis in patients with cardiogenic shock

  • A third heart sound (S3) and, frequently, a fourth heart sound (S4)

  • A systolic murmur related to dynamic obstruction of the left ventricular outflow tract

  • Rales on pulmonary examination (suggestive of left ventricular dysfunction or mitral regurgitation)

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