Hi! I have gone through your question and I understand your concern. I would write you the information you need to know about. We say that a patient has Pulmonary Regurgitation ( pulmonic regurgitation)when the blood goes from pulomonary arteria to right ventricle , normally should not be like that .The season for that is the incompetence of pulmonary valvula . Such patient when come to us they may have this clinical presentation (:the right -sided heart failure ) -Dispnea on exertion is the most common complaint -light -handedness, peripheral edema , chest pain , palpitations , syncope ,east fatigability These are the early symptoms that sometimes the patient who exsperience these symptoms may think that these are cause of anxiety or poor physical fitness. The later signs are : -abdominal dissension -ascites right user abdominal pain cause abdominal dissension. If a patient exsperience some of these symptoms need to go to the treating doctor to check their heart .The doctor will do some examination for forther evaluation such: ECG , Echogracardiography , Eco-Cooler .. to see the condition of the right ventricle and regurgitation flow. The pulmonary outflow gradient is refear to the tract from the right ventricle to pulmonary artery where the blood goes to the lungs .Any problem of this tract makes that less blood goes to the lungs , less oxygen in the blood.The patient has dispne and fatigue in severe tract instruction and the symptoms of right -sites heart failure. Hope these are helpfull to you . Thank you for using HCM for any additional question please write to me , I will be happy to answer Wish you good health.