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17 Possible Causes for Impaired Exercise Tolerance, P Pulmonale, Pulmonary Systolic Murmur

  • Eisenmenger Syndrome

    ECG: almost always abnormal; shows features suggestive of right heart hypertrophy (with tall R wave in V1, deep S wave in V6, ST and T wave abnormalities, P pulmonale) as[patient.info] Along the left sternal border systolic murmur can be heard, and early pulmonary systolic shock.[remedyland.com] Patients with pre-tricuspid shunts were older, had higher BNP concentrations and lower exercise tolerance compared to patients with post-tricuspid shunts.[ncbi.nlm.nih.gov]

  • Pulmonary Valve Stenosis

    Sixteen patients were asymptomatic with pulmonary systolic murmurs, although 6 patients presented with dyspnea.[ncbi.nlm.nih.gov] Signs Soft pulmonary systolic murmurs are more easily heard with the patient lying down.[patient.info] 1997), pulmonary valvuloplasty was considered in 22 adult patients [8 men, 14 women; mean age 28.0 years /- standard deviation (SD) 10.3; range 16-46 years] with congenital pulmonary[ncbi.nlm.nih.gov]

  • Cor Pulmonale

    In ECG, P pulmonale was observed in 58 (99.66%) of cases. 48 (80%) were having right ventricular dilatation and right atrial dilation was observed in 30 (50%) of patients.[scopemed.org] Split second heart sound with loud pulmonary component. Systolic ejection murmur with a sharp ejection click over the pulmonary artery (advanced sign).[patient.info] Tall tented p-pulmonale may also be seen. 3) Echocardiography may show dilatation and also allows indirect measurement of pulmonary artery pressures.[healthengine.com.au]

  • Atrial Septal Defect

    MurmursPulmonary ejection systolic murmur – Increased pulmonary flow • Tricuspid murmur – is heard over left sternal edge louder on inspiration • Graham-Steell murmur[slideshare.net] There is further turbulent flow into the pulmonary artery causing the systolic murmur.[easyauscultation.com] Typically, pulmonary valve stenosis has an associated systolic ejection click, the murmur of pulmonary valve stenosis tends to be more harsh than the systolic murmur associated[clinicaladvisor.com]

  • Pulmonary Hypertension

    […] failure – increased JVP, (large V waves), parasternal heave, TR murmur, hepatomegaly, peripherial oedema other signs of CHF hypoxaemia INVESTIGATIONS Bedside ECG – RVH, RAD, p-pulmonale[lifeinthefastlane.com] Clinical signs include right ventricular (parasternal) heave, a loud pulmonary second heart sound, murmur of pulmonary regurgitation, systolic murmur of tricuspid regurgitation[patient.info] […] capacity, reduce exercise tolerance, 87 induce iron deficiency, 24 and increase the risk of stroke. 88 If phlebotomy is performed, iron status should be monitored closely[doi.org]

  • Congenital Heart Disease

    […] ejection-type murmurs at the left lower sternal border over the pulmonary area Anemia Weight gain The current medication regimen should also be reviewed for appropriate indications[doi.org] […] veins with prominent A and V waves Diffuse, displaced left ventricular impulse; palpable RV impulse Increased first heart sound; persistent splitting of second heart sound Systolic[doi.org]

  • Congestive Heart Failure

    In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed.[nlm.nih.gov] The characteristic apical systolic murmur may be absent in patients with severe MR, due to the abrupt and severe elevation of left atrial pressure.[doi.org] The impairment of exercise tolerance indicated by NYHA classification was markedly improved by PD for both groups.[ncbi.nlm.nih.gov]

  • Heart Failure

    In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed.[medlineplus.gov] The characteristic apical systolic murmur may be absent in patients with severe MR, due to the abrupt and severe elevation of left atrial pressure.[doi.org] Numerous mechanisms unrelated to hemodynamic dysfunction may underlie impaired exercise tolerance in patients with chronic heart failure.[doi.org]

  • Chronic Right-Sided Congestive Heart Failure

    pulmonale.[escardio.org] Split second heart sound with loud pulmonary component. Systolic ejection murmur with a sharp ejection click over the pulmonary artery (advanced sign).[patient.info] ., kidney stones, urinary retention ) Further tests Cardiac stress test (exercise tolerance test) to assess the functional impairment due to HF or other conditions (particularly[amboss.com]

  • Secondary Pulmonary Hypertension

    Electrocardiographic findings include an axis deviated to the right, P-pulmonale (a prominent P wave), right bundle blocks, ST and T wave changes in right sided precordials[clinicaladvisor.com] Split second heart sound with loud pulmonary component. Systolic ejection murmur with a sharp ejection click over the pulmonary artery (advanced sign).[patient.info] […] holosystolic murmur of tricuspid regurgitation systolic ejection murmur diastolic pulmonic regurgitation (in severe cases) Imaging Echocardiogram estimates pulmonary artery[step2.medbullets.com]