What are common findings of cardiovascular exam in patients with idiopathic pulmonary arterial hypertension (IPAH)?

Updated: Jul 08, 2020
  • Author: Ronald J Oudiz, MD, FACP, FACC, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Cardiovascular examination often reveals the following findings:

  • The pulmonic component of the second heart sound is usually increased, which may demonstrate fixed or paradoxic splitting in the presence of severe right ventricular dysfunction; occasionally, the second heart sound may be palpable.

  • Pulmonic regurgitation (Graham Steell murmur) may be apparent.

  • A murmur of tricuspid regurgitation can be present, and a right ventricular lift (heave) may be noted.

  • Jugular venous pulsations may be elevated in the presence of volume overload, right ventricular failure, or both; large V waves are often present because of the commonly present severe tricuspid regurgitation, and large a waves thought to be secondary to poor right ventricular compliance may also be present. [14]

  • Right-sided S3 gallop


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