Table 56. Step 3: Evaluation of symptoms.

	Symptoms
Dyspnea (NYHA FC II to IV)	Main symptom Initially with events that increase pulmonary capillary pressure May be accompanied by palpitations, hemoptysis, dysphonia, dysphagia, or cough Associated right heart failure in patients with pulmonary hypertension
Precordial pain	Especially when associated with regurgitant or stenotic aortic valvular heart disease May be caused by PH
Low output or syncope	Especially present with associated AS and MR

AS: aortic stenosis; MR: mitral regurgitation; PH: pulmonary hypertension.