- Diagnosis is often expected based on clinical examination although findings may
- Increasingly, the diagnosis of pulmonary hypertension is made with
echocardiagraphy which demonstrates increased right ventricular size and wall thickness as
well as evidence of ventricular interdependence (i.e. the septum moves with the RV instead
of the LV). In the presence of tricuspid regurgitation (which is almost invariably present
in R heart failure), pulmonary artery pressures can be estimated based on the velocity of
the regurgitant jet.
- The diagnosis is confirmed with right heart catheterization which demonstrates
elevated right atrial, ventricular and pulmonary artery pressures.
- Left atrial pressure is normal unless there is mitral stenosis or LV failure.
- In addition, measurement of chamber oxygen saturations during right heart
catheterization can be diagnostic for L to R shunts.