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The primary sign is simply that results plateau or decline despite consistent use

The effects of the medication have been further proven scientifically, with studies showing patients shedding over 15% of body weight in the shortest possible time frame while also reducing calorie loading through appetite suppression

Other causes include stenotic lesions (aortic and pulmonary stenosis, coarctation of the aorta, tetralogy of Fallot) or relative pulmonary stenosis due to increased flow from an ASD Crescendo decrescendo murmur b) Holosystolic (regurgitant) murmurs start at the beginning of S1 (pulse) and continue to S2

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