Pulmonary hypertension : Diagnosis

Pulmonary hypertension can be difficult to diagnose because the symptoms are similar to those of other heart or lungs conditions.

This means there can sometimes be a delay before a correct diagnosis is made.

See your GP if you have symptoms of pulmonary hypertension, such as breathlessness and tiredness.

Initial assessment

Your GP will ask about:

  • your symptoms and how they affect your life
  • your family history – although rare, pulmonary arterial hypertension can run in families
  • any medication you're currently taking
  • any other medical conditions you have

You may also have a physical examination where your GP will listen to your heart and lungs, and check for any swelling in your legs or ankles.

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Further tests

If your GP thinks you may have pulmonary hypertension, they'll recommend further tests.

The two main tests used to help diagnose the condition are:

  • an echocardiogram – a scan that uses high-frequency sound waves to create an image of the heart; it's used to estimate the pressure in your pulmonary arteries and test how well both sides of your heart are pumping
  • right heart catheterisation – a thin, flexible tube (catheter) is inserted into a vein in your neck, arm or groin, and passed through to your pulmonary artery to confirm a diagnosis by accurately measuring the blood pressure in the right side of your heart and pulmonary arteries; it's carried out in specialist national pulmonary hypertension centres

Other tests you may have include:

  • an electrocardiogram (ECG) – a simple test that can be used to check your heart's rhythm and electrical activity
  • a chest X-ray – to check for symptoms such as an enlarged heart or scarring in your lungs, which can cause shortness of breath
  • lung function tests – to assess how well your lungs work
  • exercise tests – where you carry out some form of exercise while your heart rate, blood pressure and oxygen levels are monitored
  • a ventilation-perfusion scan – where the amount of air and blood flow in your lungs is measured; it's used to look for blood clots that may be causing pulmonary hypertension
  • blood tests – to rule out other possible conditions, such as thyroid and liver disease

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Classifying pulmonary hypertension

If you're diagnosed with pulmonary hypertension, your condition will be classified depending on how severe your symptoms are. This is to help work out the best treatment for you.

It's usually classified into four types, where: 

  • ordinary physical activities don't cause any symptoms
  • ordinary physical activities cause symptoms, such as chest pain or tiredness, but you don't have any symptoms when resting 
  • even slight physical activities, such as moving your arms, cause symptoms, but you don't have any symptoms when resting 
  • you have symptoms when resting, which get worse with any type of physical activity

Read about how pulmonary hypertension is treated.

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