• Chest pain -- unrelated to coronary artery disease or a heart attack
• Cough
• Rapid breathing
• Shortness of breath that increases when lying flat (orthopnea)
• Sensation of feeling the heart beat (palpitations)

Note: Symptoms may start suddenly.

The doctor may detect a thrill (vibration) over the heart when feeling (palpating) the chest area. An extra heart sound (S4 gallop) and a distinctive heart murmur may be heard when listening to the chest with a stethoscope. However, some patients may not have this murmur. If fluid backs up into the lungs, there may be crackles heard in the lungs.

Blood pressure is usually normal.

The following tests may be performed:

• Cardiac catheterization
• Chest MRI scan
• Chest x-ray - may also show fluid in the lungs or prominent lung veins
• Color flow Doppler exam
• CT scan of the chest
• Echocardiogram
• ECG - usually shows a normal sinus rhythm but may show abnormal heart rhythms
• Radionuclide scans
• Right heart catheterization - may show high left atrial pressure.
• Transesophageal echocardiogram (TEE)