Clinical features

Patients with early PH may be asymptomatic.

• Common clinical features

  • Dyspnea and/or syncope on exertion

  • Chest pain

  • Fatigue

  • Cyanosis

  • Clinical features of underlying etiology (e.g., COPD, OSA, PE)

• Hoarseness

• Cough, hemoptysis

• Loud and palpable second heart sound (often split)

• Jugular vein distention

• Symptoms of right heart failure (e.g., palpitations, peripheral edema, hepatojugular reflux)

• Nail clubbing

• Parasternal heave

-> Clinical symptoms may be inconspicuous, especially in the early stages when symptoms of underlying diseases such as COPD may eclipse those of PH.