Symptoms of PH are mainly linked to right ventricle (RV) dysfunc- tion, and typically associated with exercise in the earlier course of the disease.25,26 The cardinal symptom is dyspnoea on progressively minor exertion. Other common symptoms are related to the stages and severity of the disease, and are listed in Figure 2.60–62 Potential clinical signs and physical findings are summarized in Figure 3.60,61 Importantly, the physical examination may also be the key to identi- fying the underlying cause of PH (see Figure 3).