Pulmonary hypertension is classified into 5 categories based on the underlying pathophysiology: (1) pulmonary arterial hypertension, (2) pulmonary hypertension due to left heart disease, (3) pulmonary hypertension due to lung diseases/hypoxemia, (4) chronic thromboembolic pulmonary hypertension, and (5) miscellaneous. Echocardiography, chest imaging, pulmonary function tests, and right heart catheterization are used in evaluating and diagnosing pulmonary hypertension.

1. Classification & Diagnosis of Pulmonary Hypertension

11. Identification of pulmonary hypertension clinical class

20. Pulmonary arterial hypertension evaluation

25. Summary History+ physical examination+ ECG+ chest x-ray Evidence of PAH Evidence of PAH No further evaluation Echo- Doppler Structural cardiac abnormality Pulmonary function test Normal Arterial blood gas analysis No further evaluation Yes No Yes No Primary cardiac disease Restrictive pattern Evaluate for ILD Obstructive pattern COPD Yes No

26. Arterial blood gas analysis No hypercapnia Is any evidence of pulmonary thromboembolism Cardiac catheterization Hypercapnia Evaluate for hypoventilation syndrome Yes No Thromboembolic PAH Definitive diagnosis Acute vasodilator challenge Summary cont….