Which of the following features indicates the presence of hea disease in pregnancy and which is not seen in normal pregnancy

Distended neck veins indicates the presence of hea disease in pregnancy Anatomical and physiological changes during pregnancy that mimic cardiac disease Hyperdynamic circulation Systolic ejection murmur at left sternal border( due to increased blood flow across the aoic and pulmonary valves) Dyspnea, decreased exercise tolerance,fatigue,syncope Tachycardia,shift of ventricular apex Continous murmur at 2nd n 4th intercostal space-mammary souffle Loud first sound with splitting. Symptoms in Cardiac disease Dyspnea Ohopnea Paroxysmal nocturnal dyspnea Hemoptysis Syncope Chestpain Signs Cyanosis Clubbing Persistant neck vein distension Thrill, Parasternal heave Grade 3 systolic murmur Diastolic murmur Cardiomegaly Arrhythmias, Atrial Fibrillation Persistant Split 2nd sound, Loud P2 ECG: T wave inversion , Biatrial enlargement ,dysrhythmias Reference: Textbook of Obstetrics; Sheila Balakrishnan; 2nd edition; Page no: 230