43 y/o f, bmi of 30, recently developed heart murmer (grade 2, early syst) and heart palps. average resting hr of 45 according to fitbit. recently had an echo done, all normal besides right systolic pressure 45mm. should i be concerned?

Grade 2 early systolic murmur could be entirely benign but your physician is in a better position to comment further. The right ventricular systolic pressure of 45 mm is elevated, but remember that this is a calculated value and the reliability depends on the quality of the echo and the Doppler. A confirmation of this calculated right ventricular pressure needs to be done by the echo reader.