Physical examination |
Increased intensity of arterial pulses |
Cephalic and lateral displacement of the point of maximum impulse |
Prominent splitting of the second heart sound |
Systolic murmur in the pulmonary and tricuspid areas |
Enhancement of preexisting murmurs |
Systolic-diastolic murmur heard over 1 or both breasts (“mammary souffle”)10 |
Electrocardiogram |
Left axis deviation |
Left atrial dilatation |
Q-wave and T-wave inversion in III |
Q wave in aVF |
T-wave inversion in V1, V2, and V3 |