Pulmonary hypertension (PH) is diagnosed through a combination of tests, with right-heart catheterization being the most definitive.
Diagnostic Process for Pulmonary Hypertension
Diagnosing PH typically involves a multi-step approach to confirm the presence of elevated pulmonary artery pressure and to identify the underlying cause.
Initial Assessment
- Medical History and Physical Examination: The doctor will review your medical history, focusing on conditions that might contribute to PH, and conduct a physical exam to look for signs of the disease.
- Echocardiogram: This non-invasive test uses sound waves to create images of the heart, allowing doctors to estimate the pressure in the pulmonary arteries. While it is not definitive, an echocardiogram can suggest the likelihood of PH and prompt further testing.
Confirmatory Testing
- Right-Heart Catheterization: According to available references, this is the gold standard for diagnosing PH. This invasive procedure involves inserting a catheter into the right side of the heart and pulmonary arteries to directly measure pressures. "This is the only test that directly measures the pressure inside the pulmonary arteries, and it should be done in all patients at least once to confirm a patient's diagnosis of PH."
- Pulmonary Function Tests: Evaluate lung function and can help distinguish between different types of pulmonary hypertension.
- Ventilation/Perfusion (V/Q) Scan or CT Scan: These imaging tests assess blood flow and air flow in the lungs to look for blood clots or other abnormalities that could cause PH.
- Blood Tests: A variety of blood tests can help identify underlying conditions that may be contributing to PH, such as autoimmune diseases, infections, or genetic mutations.
Summary Table
| Test | Purpose |
|---|---|
| Echocardiogram | Initial screening to estimate pulmonary artery pressure |
| Right-Heart Catheterization | Definitive diagnosis by directly measuring pulmonary artery pressure |
| Pulmonary Function Tests | Evaluate lung function |
| V/Q Scan or CT Scan | Assess blood flow and air flow in the lungs |
| Blood Tests | Identify underlying conditions |
