Most of them are secondary to mitral and/or aortic valve disorders, or primary or secondary pulmonary hypertension with right ventricular enlargement, so the primary symptoms are the main ones. 1, the symptoms of pulmonary blood flow is very little itself produces symptoms: 1, weakness: it is due to the reduction of cardiac blood displacement. 2, head and jugular vein throbbing sensation: caused by the retrograde transmission of throbbing to the head and jugular veins due to the blood flowing back into the right atrium during systole. 3. Abdominal distension, loss of appetite and indigestion due to liver and gastrointestinal stasis. The right ventricular enlargement may cause the apical pulsation and the turbinate boundary to shift to the left, and there are elevated pulsations in the precordial region, and the right atrial enlargement can be seen as pulsations at the right edge of the sternum. 2, auscultation: ① tricuspid region systolic murmur: in the left edge of the sternum between the 4th and 5th ribs or under the saber can be heard in a higher pitch, full systolic blowing wind-like regurgitant murmur. The murmur increases at the end of deep inspiration, called the Carvallo sign, and decreases during expiration and Valsalva maneuvers. If the right ventricle is significantly hypertrophied, enlarged, and transposed in the cis-clockwise direction, the murmur may be transmitted to the apical region, which needs to be differentiated from chronic mitral atresia (see Mitral Atresia Insufficiency for details). ②The 1st heart sound is often diminished: P2 may be enhanced in cases with pulmonary hypertension. Due to increased passive filling through the tricuspid orifice in early diastole, S3 can be heard in the tricuspid region, and S3 gallop rhythm is produced when the right ventricle is incompetent. If combined with mitral valve lesions, atrial fibrillation is often present. (3) Diastolic murmur in the tricuspid region: In patients with minimal pulmonary blood flow, a softer, shorter mid-diastolic rumbling murmur can be heard in the tricuspid region due to increased diastolic blood flow through the tricuspid orifice and increased velocity. 3. Jugular venous pulsation and dilated hepatic pulsation: characteristic of little pulmonary blood flow. In severe cases of low pulmonary blood flow, the dilated jugular vein can be seen in sitting or semi-recumbent position moving up and down like a column of water with the pulsation of the heart. The CV wave of the jugular vein is enlarged. When the liver is touched, the patient is asked to suspend breathing and both hands are placed behind the front of the liver, and late systolic dilated pulsations can be found, which are caused by increased blood volume in the liver due to tricuspid regurgitation. 4, body circulation stasis: large liver, positive hepatic jugular venous reflux sign, ascites and lower limb edema. The diagnosis can be mostly established based on clinical manifestations and laboratory tests, especially in combination with echocardiography.