Pulmonary hypertension. Would symptoms present before right sided heart enlargement began?

PH. While symptoms of pulmonary hypertension (ph) often correlate with right ventricular size and function, it possible to have symptoms, particularly with heavy exertion, early in the disease state.
PAH. Appearance of symptoms with pah can be varied in timing in the course of pulmonary hypertension. Generally present by right sided enlargement appearance but...