Clinical features
Symptoms include:
- fatigue
- breathlessness is not severe and, characteristically, occurs on exertion and not at rest
- swelling of abdomen and ankles - ascites is more prominent feature than peripheral oedema
Signs include:
- small pulse:
- pulsus paradoxus
- atrial fibrillation
- tachycardia
- Kussmaul's sign (a raised JVP with inspiration); dominant y descent and trough
- cardiac impulses: barely palpable; characteristic is systolic retraction at the apex
- pericardial knock (loud-high pitched S3) following S2
- hepatomegaly
- ascites
- ankle swelling
Reference:
- Braunwald E (2011). Heart Disease - A Textbook of Cardiovascular Medicine,WB Saunders.
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