distant heart sound; muffled heart sound

Introduction

Diminished or quiet heart sounds when the chest is auscultated with a stethoscope.

Etiology

• COPD
• obesity
• restrictive cardiomyopathy (NEJM knowledge+ claims no muffled heart sounds)
• pericarditis
• pericardial effusion (breast cancer & lung cancer most common)
  • pericardial tamponade
• rheumatic fever
• pneumothorax
• acute myocardial infarction
• hypothyroidism
• Addison's disease
• panhypopituitarism
• hypovolemia
• beta-blocker toxicity