Your health care provider or PH specialist may order several of the tests below. Not everyone needs all of them. Your specialist will choose the tests that are right for you.
1. Electrocardiogram (ECG or EKG)
An ECG is a quick, painless test that records the electrical signals of your heart. It may show whether the right side of your heart is working harder than normal.
An ECG alone cannot diagnose PH.
2. Chest X-ray or CT Scan
These imaging tests take pictures of your heart and lungs.
They can show:
- Enlarged pulmonary arteries
- Lung diseases like emphysema or scarring
- Signs of old or new blood clots
A CT scan gives more detail than a regular X-ray.
3. Pulmonary Function Tests (PFTs) and DLCO
These tests measure how well your lungs move air and how well oxygen passes into your bloodstream.
They help your care team determine:
- Whether lung disease is present
- Whether lung problems are causing or contributing to PH
- If low oxygen levels may be part of the problem
The DLCO test is especially helpful for showing how well oxygen transfers from the lungs into the blood.
4. Blood Tests
Bloodwork can look for health conditions that may cause PH, such as:
- Autoimmune diseases
- Thyroid problems
- Liver disease
- HIV
It also measures heart markers like BNP, which help show how hard the heart is working.
5. Sleep Study or Overnight Oxygen Check
Some people have breathing problems during sleep—such as sleep apnea—that can worsen PH or mimic PH symptoms. These tests check your oxygen levels and breathing patterns while you sleep.
If sleep apnea or low nighttime oxygen is found, treatment can improve symptoms and help protect your heart.
6. Six-Minute Walk Test (6MWT)
This simple test measures how far you can walk in six minutes. It helps your care team understand:
- Your exercise capacity
- How your heart and lungs respond to activity
- How your symptoms change over time
It is often repeated throughout your care to track progress.
7. Advanced Imaging Tests
Ventilation/Perfusion (V/Q) Scan
Shows how air and blood move through your lungs and can detect blood clots that may cause PH.
CT Angiography / Chest CT
Shows the pulmonary arteries in detail and can find narrowing, clots, or scarring.
Cardiac MRI
Provides highly detailed images of the heart and helps your PH specialist evaluate how the right side of the heart is functioning and adapting to PH.
A right heart catheterization (RHC) is the only way to know for sure whether you have pulmonary hypertension.
What Happens During an RHC?
A thin tube (catheter) is placed into a vein in your neck, arm, or groin.
The catheter is guided into the right side of your heart and then into the pulmonary artery.
The specialist measures the pressures in your heart and lungs and checks how blood flows through the pulmonary arteries.
You are usually awake but may receive medicine to help you relax. The test typically takes about an hour.
Why Is It Needed?
RHC is the only test that can:
- Confirm whether you truly have PH
- Show the type of PH
- Measure how severe PH is
- Guide decisions about the best treatment
Before starting advanced PH medications, you should have a right heart catheterization (RHC). This test helps confirm the diagnosis and guides the right treatment
Genetic Testing
If PH may run in your family, or if no clear cause is found, your provider may recommend genetic testing.
Cardiopulmonary Exercise Testing (CPET)
A more detailed type of exercise test that shows how your heart, lungs, and muscles work together during activity.
Once PH is confirmed, your PH team will review all your results together—imaging, lung tests, bloodwork, sleep studies, and RHC findings.
This combined information helps them design a personalized treatment plan that fits your type of PH, your symptoms, and your health goals.
