While percussing the borders of the heart, the nurse picks up an area of dullness beginning at the 5th left intercostal space and moving upward to the 2nd left intercostal space at the sternal border. What do these findings indicate?
A.
Expected finding.
B.
Cardiac enlargement.
C.
Benign variation.
D.
Cardiac atrophy.
The correct answer and Explanation is :
The correct answer is B. Cardiac enlargement.
Explanation:
Percussion of the heart is a technique used to determine the size and borders of the heart, though it is less commonly used in modern practice due to advancements in imaging techniques like echocardiography. When percussing the heart, dullness is expected over the cardiac silhouette, but changes in the pattern and extent of this dullness can indicate abnormalities.
In a normal heart, dullness is generally noted over the area of the heart’s borders, which typically spans from the 2nd to the 5th intercostal spaces. If dullness is detected over a larger area than expected, or if it extends beyond the typical borders, it suggests that the heart is enlarged. This enlargement could be due to various conditions such as heart failure, hypertrophy (thickening of the heart muscle), or cardiomyopathy (disease of the heart muscle).
In this case, the finding of dullness beginning at the 5th left intercostal space and extending up to the 2nd left intercostal space at the sternal border indicates that the heart’s borders have expanded beyond their normal limits. This suggests that the heart is enlarged and is an indication of possible cardiac enlargement. This enlargement could be associated with conditions like congestive heart failure, left ventricular hypertrophy, or dilated cardiomyopathy.
While some benign variations in percussion findings might occur, the described pattern of dullness over a broad area is more indicative of pathological enlargement rather than a normal or benign variation. Cardiac atrophy is less commonly used in clinical terms, and this condition typically would not cause the described pattern of percussion findings.
Overall, the significant increase in the area of dullness seen here strongly points to cardiac enlargement as the underlying issue.