The evaluation of pulmonary hypertension begins with a history and physical examination.

Physical findings in someone with pulmonary hypertension may include:

• Ascites:
• A collection of fluid in the abdomen
• Swollen neck veins
• Enlarged liver
• Leg swelling
• Foot swelling (bilateral)

Tests are necessary to make the diagnosis of pulmonary hypertension.

Tests that may be used to evaluate pulmonary hypertension include:

• Chest x-ray
• May show an enlarged heart
• Echocardiogram
• Electrocardiogram
• EKG may show an enlarged heart
• Pulse oximetry or arterial blood gases:
• Measures the oxygen level in the bloodstream
• Pulmonary angiogram:
• Dye is injected into the lung arteries, and x-rays show the flow of dye through the arteries
• CT pulmonary angiogram:
• Dye is injected into the bloodstream before a CT scan is performed.
• Right-sided heart catheterization (Swan-Ganz catheter):
• Used to measure the blood pressure in the pulmonary arteries