Syncope

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

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

Abdominal Aorta Palpation

Rule in:VHAbdominal Aortic Aneurysm

POCUS

Abdominal Aorta Ultrasound

Rule in:VHAbdominal Aortic Aneurysm

Rule out:VHAbdominal Aortic Aneurysm

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

Rule out:SHAcute Coronary Syndrome, NHRib Fracture

Chest Wall Palpation

Rule in:NHRib Fracture

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 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: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

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

Brachial Artery Palpation

Rule out:VHAortic 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: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

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

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

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: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

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

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

COPD with Hyperinflation

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

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

Croup

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

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

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

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

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

Foreign Body Aspiration

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

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

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: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

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

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

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

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

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

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

Interstitial Lung Disease

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

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

Intussusception

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

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

Liver Abscess

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

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

Mainstem Bronchus Intubation

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

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

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

Opioid Intoxication / Overdose

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

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

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:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

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

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

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 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: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: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

Rule in:SHPulmonary Hypertension

Precordial Palpation

Rule out:NHPulmonary Hypertension

aka Parasternal heave; left parasternal lift

Right Ventricular Heave

Rule in:SHPulmonary Hypertension

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

Pyloric Stenosis

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

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

Rib Fracture

Rule out:SHAcute Coronary Syndrome, NHRib Fracture

Chest Wall Palpation

Rule in:NHRib Fracture

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: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

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

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

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

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