Diagnosis (according to the new Guidelines)
Diagnosing PAH involves a combination of medical history, physical examination, and various tests.
These may include:
- Electrocardiogram (ECG): to detect arrhythmias and signs of LHD
- Chest radiography: to visualize the structure of the lungs and heart
- Pulmonary function tests (PFTs) and arterial blood gases (ABG): to distinguish between PH groups and assess comorbidities
- Echocardiography: to assess the structure and function of the heart
- Ventilation/perfusion (V/Q) lung scan: to examine air flow and blood flow in the lungs
- Computed tomography (CT): to detect direct or indirect signs of CTEPH
- Cardiac magnetic resonance imaging (MRI): to assess atrial and ventricular size, morphology, and function
- Blood tests and immunology: to identify comorbidities and possible causes or complications of PH
- Abdominal ultrasound: to search for liver disease and/or portal hypertension
- Cardiopulmonary exercise testing (CPET): to assess the underlying pathophysiologic mechanisms leading to exercise intolerance
- Right heart catheterization: to measure the blood pressure in the pulmonary arteries directly