Symptoms Although presentations vary, individuals with<unk>  can experience symptoms that are associated with pulmonary hypertension, heart failure and/or a reduced cardiac output. These include: * Difficulty breathing on exertion * Chest pain (angina) on exertion * Fainting (syncope) on exertion * General fatigue/lethargy * Dizziness * Feeling of fullness in the upper abdominal area * Discomfort or pain in the right upper abdomen * Reduced appetite * Swelling (oedema) of the legs, ankles or feet * Racing heart beat (palpitations) People may rarely present with the symptoms of Ortner's syndrome, which include cough, haemoptysis and hoarseness. Signs On physical examination, the most prominent features are due to the development of right-sided heart failure. These can include a raised jugular venous pressure, ascites, left parasternal heave and a tender, enlarged liver on palpation. On inspection, patients may be chronically ill, cyanotic, cachectic and occasionally jaundiced. On auscultation, an accentuated second pulmonary sound (S2), a third heart sound termed a ‘right<unk>  gallop’, as well as a systolic murmur over the tricuspid area accentuated by inspiration may be present. On occasion, the systolic murmur can be transmitted and auscultated over the liver. Less typically, diastolic murmur may also be heard as a result of pulmonary insufficiency.
Right ventricular hypertrophy
Left ventricular hypertrophy
Right atrial enlargement
Aortic unfolding
types of Cardiomegaly
Ventricular hypertrophy
Atrial enlargement
Left atrial enlargement