Cold Extremities

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Abdominal Hernia

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Abdominal Malignancy

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Acute Abdomen

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Acute Aortic Dissection

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Acute Coronary Syndrome (Atypical Presentation)

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Acute Leukemia

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Acute Myocardial Infarction

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Acute Pericarditis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Acute Thoracic Aortic Dissection

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Adrenal Insufficiency

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Adverse Short-term Outcome in Confirmed Pulmonary Embolism

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Amyloidosis

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Aortic Coarctation

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Aortic Dissection

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Aortic Regurgitation

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Aortic Sclerosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Aortic Stenosis

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Appendiceal Mass

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Appendicitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Appendicitis (Pediatric)

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

Atrial Fibrillation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Atrial Septal Defect

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Atrioventricular Dissociation

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Autonomic Failure

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Autonomic Neuropathy

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Behçet Disease

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Bicuspid Aortic Valve

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Cardiac Tamponade

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Rule in:SHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Rule out:VHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Carotid Artery Stenosis

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Carotid Dissection

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Cecal Diverticulitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Cholangitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Cholecystitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Chronic Obstructive Pulmonary Disease (COPD) Exacerbation

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Circulatory Shock (Undifferentiated)

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Complete Heart Block

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Constrictive Pericarditis

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

COPD Exacerbation

Rule in:SHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Rule out:VHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Cor Pulmonale

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Crohn Disease (Terminal Ileitis)

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Cystitis or Urinary Tract Infection

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Deconditioning

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Dehydration

Rule in:IEDehydration, IEHypovolemia

Skin Turgor

Rule out:IEDehydration, IEHypovolemia

Dehydration in Pediatric Patient

Rule in:HHypovolemia, SHDehydration in Pediatric Patient, MHModerate-to-severe Peripheral Artery Disease +4 more

Rule out:MHDehydration in Pediatric Patient, MHHypovolemia, MHShock +3 more

Diverticular Abscess

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Ectopic Pregnancy

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Endometritis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Essential (Primary) Hypertension

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

First-degree AV Block

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Fitz-Hugh-Curtis Syndrome

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Fluid Responsiveness (Preload Responsiveness)

POCUS

Inferior Vena Cava Ultrasound

Rule in:HFluid Responsiveness (Preload Responsiveness)

Rule out:HFluid Responsiveness (Preload Responsiveness)

Gastritis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Gastroenteritis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Heart Failure

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Heart Failure with Tachycardia

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Hemorrhage

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Hepatitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Hepatomegaly

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Hyperdynamic State

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Hypertensive Emergency

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Hypertensive Heart Disease

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Hyperthyroidism (Thyrotoxicosis)

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Hypertrophic Cardiomyopathy

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Hypertrophic Cardiomyopathy with Obstruction

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Hypoglossal Nerve Palsy

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Hypotension (Systolic Blood Pressure Below 80 MmHg)

Rule in:IEHypotension (Systolic Blood Pressure Below 80 MmHg)

Radial Artery Palpation

Rule out:IEHypotension (Systolic Blood Pressure Below 80 MmHg)

Hypothyroidism

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Hypovolemia

Rule in:HHypovolemia, SHDehydration in Pediatric Patient, MHModerate-to-severe Peripheral Artery Disease +4 more

Rule out:MHDehydration in Pediatric Patient, MHHypovolemia, MHShock +3 more

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Rule in:IEDehydration, IEHypovolemia

Skin Turgor

Rule out:IEDehydration, IEHypovolemia

Hypoxemia

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Immunosuppression

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Incarcerated or Strangulated Hernia

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Increased Intracranial Pressure

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Infective Endocarditis

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

Intussusception

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Kawasaki Disease

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Large Pericardial Effusion

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Lead Poisoning

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Left Bundle Branch Block

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Liver Abscess

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Localized Arterial Insufficiency

Rule in:HHypovolemia, SHDehydration in Pediatric Patient, MHModerate-to-severe Peripheral Artery Disease +4 more

Rule out:MHDehydration in Pediatric Patient, MHHypovolemia, MHShock +3 more

Low-output State (Low Cardiac Index) Within Established Chronic Heart Failure

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Massive Pulmonary Embolism

Rule in:SHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Rule out:VHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Measles

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Medication Effect

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Mitral Regurgitation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Mitral Stenosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Mitral Valve Prolapse

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Mixed Aortic Valve Disease

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Moderate-to-severe Peripheral Artery Disease

Rule in:HHypovolemia, SHDehydration in Pediatric Patient, MHModerate-to-severe Peripheral Artery Disease +4 more

Rule out:MHDehydration in Pediatric Patient, MHHypovolemia, MHShock +3 more

Nutritional Deficiency

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Opioid Intoxication / Overdose

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Oral Cancer

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Ovarian Cyst, Torsion, or Mass

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Pancreatitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Patent Ductus Arteriosus

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Pelvic Inflammatory Disease

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Peptic Ulcer Disease

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Perforated Viscus

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Peripheral Artery Disease

Rule in:HHypovolemia, SHDehydration in Pediatric Patient, MHModerate-to-severe Peripheral Artery Disease +4 more

Rule out:MHDehydration in Pediatric Patient, MHHypovolemia, MHShock +3 more

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Peritonitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Pneumonia

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

Postpericardiotomy Syndrome

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Postural Orthostatic Tachycardia Syndrome

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Prosthetic Valve

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Pulmonary Embolism

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Pulmonary Hypertension

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Pulmonic Regurgitation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Pulmonic Stenosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Pyloric Stenosis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Right Bundle Branch Block

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Right Ventricular Infarction

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Right-sided Valvular Lesion

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Sepsis

Rule in:HHypovolemia, SHDehydration in Pediatric Patient, MHModerate-to-severe Peripheral Artery Disease +4 more

Rule out:MHDehydration in Pediatric Patient, MHHypovolemia, MHShock +3 more

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

Septic Shock

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Septic Shock (Severity Stratum Within Established Sepsis)

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Severe Anemia

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Severe Aortic Regurgitation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Severe Asthma Exacerbation

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Rule in:SHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Rule out:VHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Severe Left Ventricular Dysfunction

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Severe Metabolic Acidosis (Any Cause — Diabetic Ketoacidosis, Alcoholic Ketoacidosis, Lactic Acidosis, Salicylate Toxicity, Uremic Acidosis)

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Severe Tricuspid Regurgitation

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Shock

Rule in:HHypovolemia, SHDehydration in Pediatric Patient, MHModerate-to-severe Peripheral Artery Disease +4 more

Rule out:MHDehydration in Pediatric Patient, MHHypovolemia, MHShock +3 more

Sigmoid Diverticulitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Splenic Infarction or Rupture

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Subclavian Artery Stenosis

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Takayasu Arteritis

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Tension Pneumothorax

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Rule in:SHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Rule out:VHCardiac Tamponade, SHSevere Asthma Exacerbation, IECOPD Exacerbation +2 more

Thyroid Storm (Thyrotoxic Crisis)

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

Tricuspid Regurgitation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Tricuspid Stenosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Uremic Pericarditis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Ventricular Septal Defect

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Volume Depletion From Significant Blood Loss

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Volume Overload

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more