Massive hemoptysis

blood in sputum

Coughing pink frothy phlegm

Related to bronchial mucosal edema, pulmonary congestion, and atrial enlargement compressing the left main bronchus

Compression of the left recurrent laryngeal nerve causing hoarseness

Compression of the esophagus causing difficulty swallowing

Severe bistenosis often has a mitral valve appearance

Precordial bulge

Right ventricular enlargement may show diffuse apical beats in the precordial area or enhanced cardiac fluctuations under the xiphoid process.

Palpable diastolic tremor in apical region

The heart expands to the left relative to the dullness boundary, giving a pear-shaped heart

The S1 at the apex becomes hyperactive and beats like, and the valve opening sound can be heard. If the valve leaflets are calcified and stiff, the S1 weakens and the valve opening sound disappears.

In pulmonary hypertension, S2 in the pulmonary valve area is hyperactive or accompanied by division.

Mid to late diastolic rumble-like murmur was heard in the apical area

Pulmonary artery dilatation causes relative pulmonary valve insufficiency, and an early diastolic blow-like murmur is heard in the second intercostal space on the left sternal border.

The right ventricle was enlarged, and a holosystolic murmur was heard in the tricuspid valve area.

rheumatic heart disease

Mitral valve prolapse

Coronary heart disease papillary muscle dysfunction

Rupture of chordae tendineae

Exertional dyspnea, paroxysmal nocturnal dyspnea, orthopnea, acute pulmonary edema

Increased and diffuse apical pulse

In patients with obvious left ventricular hypertrophy, the apical pulse is shifted to the lower left and touches the lifting-like apical pulse.

In severe stenosis, carotid artery pulse is significantly delayed

Systolic tremor palpable in the second intercostal space at the right sternal border

The border of cardiac dullness expands to the lower left

S1 is normal, A2 is weakened, disappeared or reversely divided, and a (4-5)/grade 6 ejection systolic murmur can be heard in the aortic valve, which is rough, blowing, increasing-decreasing, and conducts to the neck or the left lower edge of the sternum.

The apical beat was hyperdynamic, expanded in scope, and shifted to the left and downwards

The apex beats like a lift, expands in scope, and shifts to the left and downwards

The border of cardiac dullness expands to the lower left, forming a boot-shaped heart

S1 weakens and A2 weakens or disappears

An early diastolic sigh-like murmur was heard in the 2-3 intercostal spaces on the left sternal border and in the aortic valve area.

Late diastolic rumbling murmur heard at the apex