An electrocardiogram is performed to see if there is 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, is done initially and is often used to follow the progression of the disease. An echocardiogram can show enlargement of the right side of the heart and can sometimes estimate the pressures.
A six-minute walk test is used to evaluate the exercise capacity and the response to therapy. During this test, an oxygen saturation monitor (pulse ox) is placed on the side of the head (temple), and the patient walks along the measured course at their own pace for six minutes.
The best way to make the diagnosis of 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 medicines may be used during a cardiac catheterization to see if the blood vessels in the lungs will relax in response to them. This may lower the pressures in the lungs and can help guide therapy.