How is pulmonary hypertension diagnosed?

On this page, we explain the different tests used to diagnose pulmonary hypertension.

Pulmonary hypertension can be difficult to diagnose because the symptoms are similar to many other heart and lung conditions. Most people will need to have a range of tests to get an accurate diagnosis.

Your GP will refer you to a hospital heart or lung clinic for tests, and if health care professionals there think you may have pulmonary hypertension, you will be referred to a specialist centre for pulmonary hypertension.

Tests for pulmonary hypertension include:

Echocardiogram

An echocardiogram, often called an echo, uses ultrasound to show how your heart is working. An echo can give a rough estimate of the pressure in your pulmonary arteries and how well the chambers of the heart are working. It can also tell you if you have been born with problems with your heart (called ‘congenital’) that may cause pulmonary hypertension.

Right heart catheterisation

Right heart catheterisation is used to confirm a diagnosis of pulmonary hypertension. It’s also known as cardiac catheterisation.

It gives accurate information about blood pressure in the right side of the heart and the pulmonary arteries. It’s used to confirm a diagnosis of pulmonary hypertension. A long, thin, flexible plastic tube is inserted into a vein in your groin or neck and fed through to your pulmonary artery. You’ll be given local anaesthetic, and so won’t feel this going in. You don’t usually need to stay in hospital for this test, as it can normally be done as a day test.

Other tests you might have are:

  • an electrocardiogram or ECG. This records the electrical activity of your heart. It can show possible problems with the heart’s rhythm
  • blood tests
  • lung function (breathing) tests
  • a sleep study to measure oxygen levels, heart rate and breathing patterns while you’re asleep.
  • other types of scan. These may include:
    • a CT scan of your lungs to look for lung disease and blood clots
    • a V/Q scan, which is a type of scan that looks specifically for blood clots
    • an ultrasound scan to look at your liver
    • an MRI scan to look at the function of your heart.
  • exercise or walking tests. Often a walking test involves a timed walk over 6 minutes, called a 6-minute walking test. This can be repeated, and helps monitor your progress with treatment.
  • cardiopulmonary exercise test (CPET or CPEX). This test sees how your heart, lungs and muscles react together when you exercise. It’s usually performed on a bike, where you’re monitored with wires and breathing with a mouthpiece. The test can measure the level of ‘risk’ of PAH or CTEPH, and can help make treatment decisions. This test can also be useful in helping assess the causes of breathlessness.

Next: Treating pulmonary hypertension

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