Papillary muscle rupture causes pulmonary edema (SOB, orthopnea) as the LV & LA pressure rapidly equalizes allowing no time for a systolic murmur. Restrictive muscular VSD causes no SOB & loud systolic murmur. | Cardiophilia

Left ventricular failure (LVF) is characterized by symptoms resulting from the inability of the left ventricle to pump blood efficiently, leading to congestion in the lungs. Classical signs include shortness of breath, orthopnea (difficulty breathing when lying flat), paroxysmal nocturnal dyspnea (sudden nighttime breathlessness), and fatigue. On physical examination, the patient may exhibit crackles (crepitations) on auscultation of the lungs, indicating pulmonary congestion. Swelling in the le