As with other forms of pulmonary hypertension, progressive exertional dyspnea and exercise intolerance are characteristic of thromboembolic pulmonary hypertension. In many cases, the only finding on physical examination is an accentuation of the pulmonic component of the second heart sound, which may be subtle and is easily overlooked. The symptoms are thus often attributed to other cardiopulmonary disorders, deconditioning, or even psychogenic dyspnea.