More pronounced regurgitation that is noticed through a routine physical examination is a medical sign of disease and warrants further investigation.

[medical citation needed] If it is secondary to pulmonary hypertension it is referred to as a Graham Steell murmur.

[3] However, more severe regurgitation may contribute to right ventricular enlargement by dilation, and in later stages, right heart failure.

[8] A diastolic decrescendo murmur can sometimes be identified,( heard best) over the left lower sternal border.

[12] In the diagnosis of pulmonary regurgitation both echocardiograms and ECG is used to ascertain if the individual has this condition, as well as, the use of a chest X-ray to expose enlargement of the right atrium or ventricle.