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Raised pulmonary vascular resistance

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Symptoms include:

  • fatigue - due to low cardiac output
  • hepatic pain
  • ascites
  • ankle swelling

Signs include:

  • loss of weight and cachexia

  • malar flush of mitral facies

  • pulse:
    • very small, low cardiac output
    • often, atrial fibrillation

  • jugular venous pressure - may be raised

  • cardiac impulses:
    • right ventricular hypertrophy
    • palpable P2 - due to pulmonary hypertension

  • auscultation:
  • soft opening snap is often audible. Other mitral murmurs are often difficult to hear because of low flow
  • loud P2
  • tricuspid pansystolic murmur due to tricuspid incompetence

  • liver may be enlarged and pulsatile

  • shifting dullness of ascites

  • dependent oedema due to right ventricular failure

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