What finding on a physical exam would indicate possible preeclampsia in pregnant patients?

The presence of facial edema during a physical examination is a notable finding that may indicate preeclampsia in pregnant patients. Preeclampsia is characterized by high blood pressure and often involves systemic edema due to fluid retention. Facial edema specifically can be a result of altered capillary permeability and increased intravascular volume associated with hypertension, both of which are typical features of preeclampsia.

In contrast, while the other findings may occur due to a variety of physiological changes during pregnancy or other disorders, they are not definitive indicators of preeclampsia. An increased second heart sound split with inspiration can be a normal physiological finding in pregnancy due to changes in blood volume and cardiac output. A diastolic murmur can occur in pregnant patients as a result of increased blood flow but is not specific to preeclampsia. Hypotension is generally not associated with preeclampsia, as this condition typically presents with hypertension instead. Thus, facial edema stands out as a symptom directly suggestive of preeclampsia, warranting further evaluation and monitoring of the patient.