CLINICAL FEATURES OF PULMONARY HYPERTENSION



Clinical onset may be acute or chronic, de­pending on the cause. Acute pulmonary hyper­tension is usually due to thromboembolism, and patients may complain of sudden dyspnea with or without hemoptysis and pleuritic chest pain. Physical examination is frequently normal or may reveal tachypnea, a loud P2, a right ventricular heave, and a pleural rub or effusion. Gradually progressive dyspnea is the major symptom Of chronic pulmonary hypertension and in addition to a loud P2 and right ventricular heave, features of right heart failure—i.e., elevated jugular ven­ous pressure, tender hepatomegaly, and pedal edemmay be found.