Paroxysmal Nocturnal Dyspnea

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 Hepatitis

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 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

Anaphylaxis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

Atelectasis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Atelectasis with Patent Airway

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

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

Baker Cyst Rupture

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +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

Bronchial Obstruction

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Bronchiectasis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Bronchitis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

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

Cardiogenic Pulmonary Edema (Acute Decompensated Heart Failure)

POCUS

Lung Ultrasound (Parenchymal)

Rule in:HCardiogenic Pulmonary Edema (Acute Decompensated Heart Failure)

Rule out:HCardiogenic Pulmonary Edema (Acute Decompensated Heart Failure)

Cardiomegaly

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 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

Cellulitis

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Chronic Obstructive Pulmonary Disease

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

Chronic Venous Insufficiency

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 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

Cirrhosis

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 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

Congestive Hepatopathy

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Constrictive Pericarditis

Rule in:SHHeart Failure, IEConstrictive Pericarditis, IERight Heart Failure

Rule out:SHTricuspid Regurgitation, IEConstrictive Pericarditis, IERight Heart Failure

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

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

COPD with Hyperinflation

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Cor Pulmonale

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

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

Croup

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Deep Vein Thrombosis

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Lower Extremity Inspection and Palpation

Rule in:HPeripheral Arterial Disease, SHHeart Failure, MHDeep Vein Thrombosis

Rule out:MHDeep Vein Thrombosis, MHHeart Failure

Dextrocardia

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Epiglottitis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Esophageal Rupture

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

Fatty Liver Disease

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 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

Foreign Body Aspiration

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Heart Failure

Rule in:SHHeart Failure, IEConstrictive Pericarditis, IERight Heart Failure

Rule out:SHTricuspid Regurgitation, IEConstrictive Pericarditis, IERight 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:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

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

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

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Lower Extremity Inspection and Palpation

Rule in:HPeripheral Arterial Disease, SHHeart Failure, MHDeep Vein Thrombosis

Rule out:MHDeep Vein Thrombosis, MHHeart Failure

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Neck Vein Inspection

Rule in:HHeart Failure

Rule out:MHHeart Failure

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 (Bedbound Patient)

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Heart Failure (When Wheezing Is the Dominant Auscultatory Finding)

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

Hepatitis

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Hepatocellular Carcinoma

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 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

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 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

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

Hypoalbuminemia

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Hypothyroidism (Myxedema)

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Hypovolemia

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

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

Increased Intracranial Pressure

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

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

Interstitial Lung Disease

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

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

Left Ventricular Dilation

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Left Ventricular Hypertrophy

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Lipedema

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Lobar Pneumonia or Consolidation

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

Lymphedema

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Mainstem Bronchus Intubation

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Medication Effect (Calcium Channel Blockers, NSAIDs)

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Metastatic Liver Disease

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 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

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 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

Nephrotic Syndrome

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Obesity

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 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

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

Pericardial Effusion

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Peripheral Arterial Disease

Lower Extremity Inspection and Palpation

Rule in:HPeripheral Arterial Disease, SHHeart Failure, MHDeep Vein Thrombosis

Rule out:MHDeep Vein Thrombosis, MHHeart Failure

Peripheral Artery Disease

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

Pleural Effusion

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pleural Inflammation

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pneumomediastinum

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pneumonia

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

Pneumothorax

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

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 Edema

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pulmonary Embolism

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

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

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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 Fibrosis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

Pulmonary Mass

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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

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 Heart Failure

Rule in:SHHeart Failure, IEConstrictive Pericarditis, IERight Heart Failure

Rule out:SHTricuspid Regurgitation, IEConstrictive Pericarditis, IERight Heart Failure

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

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

Severe Aortic or Mitral Regurgitation

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 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

Severe Hypoalbuminemia

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 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

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

Tricuspid Regurgitation

Rule in:SHHeart Failure, IEConstrictive Pericarditis, IERight Heart Failure

Rule out:SHTricuspid Regurgitation, IEConstrictive Pericarditis, IERight 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:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 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

Unilateral Pulmonary Process (Consolidation, Effusion, Pneumothorax, or Atelectasis)

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Upper Airway Obstruction

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 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