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Describe Examination of chest and abdominal ?
As already mentioned earlier, any overt deformity of the chest, for example kyphosis, scoliosis, pectus exacavatum and pectus carcinatum are to be noted as anyone these may displace the apex beat producing apparent cardiomegaly. Even pectus excavatum can cause functional systolic murmur at left sternal border due to pressure from without.
A large descending thoracic aneurysm can produce a thrusting pulsation in left sterna border called Thoracic jerk.
Percussion of 2nd intercostals space is very important as obliteration of resonance always indicate enlargement of large arteries either pulmonary, aorta or sometimes both. An aneurysm of ascending can produce pulsation in right 1st and 2nd interspace. Excessive pulsation of intercostal arteries in back can be seen and felt especially on stooping forward while standing in case of severe coarctation of Aorta with large collateral vessels.
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