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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The diagnosis of pulmonary hypertension requires clinical suspicion based on the signs and symptoms as described above, a detailed medical history and physical examination, and evaluation of other conditions that may lead to pulmonary hypertension.

The best available test (gold standard) for diagnosing pulmonary hypertension is a right heart catheterization and measurement of blood pressure in the pulmonary arteries.

• In this test, a catheter is inserted into the right side of the heart via one of the large surface veins (femoral vein in the groin or subclavian vein under the clavicle).
  
  
• The catheter is connected to a pressure monitor and can measure the pressure in the right side of the heart and the pulmonary blood vessels.
  
  
• This is an invasive test and usually done in specialized centers or university hospitals by highly trained physicians.
  
  
• Pulmonary hypertension is diagnosed if the pressure in the right heart catheterization is greater than 25mmHg. Depending on how high the pressure is, the condition may be classified as mild, moderate, or severe pulmonary hypertension.

Another less invasive method to measure pulmonary artery pressure is by an echocardiogram (an ultrasound of the heart). An echocardiogram can estimate the blood pressure in the pulmonary blood vessels. It can also provide a visual image of the chambers and valves of the heart as well as show the functioning of the heart.

Typically other tests are performed to diagnose the underlying disease associated with pulmonary hypertension. These tests may include electrocardiogram (EKG, ECG), chest X-ray, CT scan of the chest, and a variety of types of blood tests pertinent to the underlying conditions.