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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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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