I'm going to take the CPET tomorrow, right before that, last night I was again waken up by SOB. This time I used stethoscope and found wide split S2 at pulmonic area, exhalation narrows A2 and P2 but does not overlap, which makes sense because I have IRBBB, trace the sound along the left sternal border, I was shocked because I can hear P2 loud and clear all the way to Tricuspid area. Although I didn't hear any at Mitral, but this is loud P2.
At both T and M I can hear either split S1 or pulmonary ejection click, no matter which one it is, the loud P2 is already clear indication of quite significant Pulmonary Hypertension if I'm not mistaken.
How can that be possible? I had echocardiogram in July and MRI in Aug, all normal.