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[S&S]
1. forward decrease -> low C.O -> fatigue / exertional dyspnea -> LV failure
2. backflow -> LA pressure increase -> pulmonary HTN
3. chronic -> LV enlargement -> Atrial Fib.(intermitten or persistent)
[PE]
1. heart sound
a. S1 diminish
b. wide splitting S2
c. S3
2. murmur
a. holosystolic murmur; in apex, radiate to axilla; high pitch
b. post. leaflet -> also in aortic area <- D/D:AS (don't radiate to carotid a.)
c. ant. leaflet -> loud, radiate to back, top of head
d. handgrip -> intense ; Valsalva -> decrease
3. pulse
a. similar to bounding pulse (AR), but pulse pressure normal
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