A Contemporary Systematic Approach to Assessing the Patient with Heart Failure with Reduced Ejection Fraction: Multimodal Noninvasive and Invasive Evaluation

Table 2

Physical exam findings of pulmonary hypertension.

Sign	Implication
Central cyanosis	Hypoxemia, right to left shunt
Clubbing	Congenital heart disease, pulmonary venopathy
Cardiac auscultation: murmurs, opening snap, gallop	Congenital or acquired heart or valvular disease
Rales, dullness, decreased breath sounds	Pulmonary congestion or effusion
Fine rales, accessory muscle use, wheezing, and prolonged expiration, productive cough	Pulmonary parenchymal disease
Obesity, kyphoscoliosis, enlarged tonsils	Disordered ventilation
Sclerodactyly, arthritis, rash	Connective tissue disorder
Peripheral venous insufficiency or obstruction	Venous thrombosis

Adapted from Mayo Board Review Table 79.3 (page 736).