How is PPH Diagnosed?
A good history and physical exam can give the physician clues to the diagnosis. An electrocardiogram should be performed which will show enlargement of the right side of the heart. A chest X-ray may show enlargement of the size of the heart, and is often a good way to follow the patient’s heart size over time. An echocardiogram, or ultrasound of the heart, will be performed initially and can also be used to follow the progression of the disease. An echo can show enlargement of the right ventricle and can sometimes estimate the pressures of the right ventricle and pulmonary arteries. The gold standard for making the diagnosis of primary pulmonary hypertension is a cardiac catheterization. This will actually measure the pressures on the right side of the heart and the resistance of the blood vessels in the lungs. Various drugs may be used during a cardiac catheterization to determine if the blood vessels in the lungs will relax in response to them. This may lower the pressures in the lun
