Pulmonary Hypertension: Diagnosis

Your doctor will pay attention to your medical and family histories and will likely perform a physical examination. More specific tests that evaluate the health of the lungs and heart may also be performed. Such diagnostic tests and procedures include the following:

• Echocardiography. This test uses sound waves to produce an image of the heart, showing how well it's working. It can help determine which areas of the heart are having problems and help identify any damage to the heart.
• Chest x-ray. An x-ray can show heart enlargement, fluid in the lungs, and lung disease.
• EKG (electrocardiogram). This measures how fast your heart is beating and looks for an irregular heart rhythm. It also determines if your heart walls are thicker than normal and whether or not you've previously had a heart attack.
• Right heart catheterization. This procedure measures the pressure in your pulmonary arteries. It also shows how well your heart is pumping blood to the rest of your body. Right heart catheterization can find any leaks between the left and right side of the heart. A thin, flexible tube called a catheter is put into a blood vessel in your arm, upper thigh, or neck and threaded to your heart to study the interior of coronary arteries.
• Lung function tests. Lung function tests measure the size of your lungs, how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. These tests can help find an underlying lung disease.
• Overnight oximetry. This test measures the level of oxygen in your blood overnight. Overnight oximetry can be done at home or in a sleep lab.
• Lung ventilation/perfusion (VQ) scan. This test measures air and blood flow in your lungs. A lung VQ scan can show whether there are blood clots in your lung's blood vessels.
• Blood tests. Blood tests are used to rule out other diseases, such as HIV, liver disease, and autoimmune diseases.
• Exercise testing. In an exercise test, you perform a physical activity, such as jogging on a treadmill, to increase the speed of your heartbeat. This helps determine how well your heart performs when it must work.

This information has been adapted from the National Heart Lung and Blood Institute.