Prompt diagnosis is often a challenge for healthcare professionals because PAH can easily be misdiagnosed as chronic lung disease (e.g. asthma or COPD), or heart disease. In younger women the early stages of the symptoms of PAH can be misinterpreted as depression.
As a result there can be significant delay in receiving a diagnosis, frequently more than two years.
Once a doctor suspects PAH, he or she will want to review the patient’s medical and family history, perform a physical examination and organize for one or more diagnostic tests to be carried out. The diagnostic tests are to either confirm or exclude a diagnosis of PH. Because the symptoms of PAH are not specific to the disease, diagnosis often follows a logical sequence of steps.
Which tests are chosen will be different for each person, depending on the outcome of the previous test. These tests could include any of the following:
- An electrocardiogram (ECG) records the heart's electrical activity by connecting electrodes to the individual’s chest.
- A chest x-ray develops images of the heart, lungs, airways, blood vessels and the bones in the chest.
- An echocardiogram uses ultrasound to produce moving, real-time images of the heart. The procedure monitors heart function and provides information on the structure of the heart.
- The Six-minute walk test measures how far you can walk up and down a corridor in six minutes.
High-resolution computed tomography (CT or HRCT)
- High-resolution computerised tomography scanning uses X-rays to produce detailed images of the inside of the body, including cross sections through the heart and lungs.
- Magnetic resonance imaging (MRI) uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.
Right heart catheterization
- A right heart catheterization is used to determine how well the heart is functioning and measures the pressure in the heart and lungs. A small tube called a catheter is guided into the pulmonary artery, allowing healthcare professionals to observe blood flow between the heart and lungs.
Ventilation-Perfusion lung scan (V/Q Scan)
- A V/Q scan measures air and blood flow in your lungs and is most often used to help diagnose or rule out a pulmonary embolism.
Pulmonary function tests
- A group of non-invasive tests that assess disease in the lung tissue, such as emphysema or pulmonary fibrosis.