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Pulmonary Hypertension: Diagnosis

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This information was reviewed and approved by Marjorie Patricia George, MD (7/1/2019).

Because the symptoms of pulmonary hypertension can look like symptoms of more common diseases (e.g., COPD, asthma, sleep apnea), the diagnosis of pulmonary hypertension can be challenging and is often delayed until the disease has progressed.

When suspecting pulmonary hypertension, the first step is getting an ultrasound of the heart, or echocardiogram, which can provide an estimate of the pressure in the lungs.

Only a procedure called a right heart catheterization (RHC) can directly measure blood pressure in the lungs and determine if pulmonary hypertension is present. Doctors use the pattern of numbers from the heart catheterization, along with the patient’s other testing, to determine whether the patient has pulmonary hypertension, and if so, what type. This helps determine the best course of therapy for each patient.

Other tests are performed to look for associated diseases, including blood tests, electrocardiogram (EKG), chest X-ray, pulmonary function tests and a test for chronic blood clots in the lung called a ventilation/perfusion scan (VQ scan). A six-minute walk time is typically performed to assess a person’s exercise capacity and need for oxygen therapy. It is also important for patients to have a sleep study or a nighttime oxygen test.

While the testing can be intensive, especially at the time of diagnosis, these data are essential to mapping out a personalized plan to help the patient with pulmonary hypertension live and breathe better.

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