It is difficult to make a pulmonary arterial hypertension (PAH) diagnosis based just on symptoms, and there is no single test that confirms whether someone has the disease. An initial evaluation usually includes a medical history, physical exam, and blood tests.
Physical Exam for Pulmonary Hypertension Signs:
- Heart sounds
- Fluid buildup
- Signs of poor circulation
Testing Blood for Signs of PAH:
- Oxygenation1
- Excess blood cells
In addition to ruling out other conditions, additional tests can provide important information about exercise capacity, symptoms, and the function of your lungs:
- 6-minute walk distance
- Pulmonary function class testing
- Cardiopulmonary exercise testing1
- Borg dyspnea test
Diagnostic tests
Diagnostic tests are given to find typical signs of PAH (pulmonary arterial hypertension).1:
- Chest x-rays
- Doppler echocardiograms ("echo")
- Right heart catheterization
- Electrocardiogram (ECG)
- Laboratory tests
Signs of PAH that can be found on a chest x-ray:
- Cardiac enlargement
- Prominent pulmonary artery near the heart
Signs of PAH that can be found on an echocardiogram with doppler:
- Right heart growth
- Flattening of intraventricular septum
- Small, D-shaped left ventricle1

Right heart catheterizationdiagnostic gold standard2
The "right heart cath" is considered the only way to make pulmonary arterial hypertension (PAH) a definitive diagnosis. The test allows your physician to see the inside of the chambers in the right side of your heart and to directly measure pressures in the pulmonary arteries.
Read about:
What is PAH?
Signs and Symptoms
Treating PAH
Living with PAH
PAH Learning Center
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