Clinical features
Symptoms include:
- chest pain, exertional dyspnoea, fatigue, syncope
- other symptoms due to the cause of the pulmonary hypertension, if not primary pulmonary hypertension, will be present
Signs of pulmonary hypertension include:
- small volume pulse
- peripheral cyanosis
- a raised jugular venous pulse, with a prominent a wave
- a parasternal - right ventricular - heave
- in the later stages, peripheral oedema
There may also be:
- a loud pulmonary component to the second heart sound
- a right ventricular fourth heart sound click
- a mid-diastolic systolic ejection murmur
- a Graham Steel murmur
All these heart murmurs will probably only ever be heard by the skilled cardiologist.
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