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    Pulmonary Arterial Hypertension

    Getting a Diagnosis continued...

    Your doctor may order tests, including:

    Echocardiogram: This ultrasound picture of the beating heart can check blood pressure in the pulmonary arteries.

    CT scan: This can show enlarged pulmonary arteries. A CT scan can also spot other problems in the lungs that could cause shortness of breath.

    Ventilation-perfusion scan (V/Q scan): This test can help find blood clots that can cause high blood pressure in the lungs.

    Electrocardiogram (EKG or ECG): An EKG traces the heart's activity and can show whether the right side of the heart is under strain. That's a warning sign of pulmonary hypertension.

    Chest X-ray: An X-ray can show if your arteries or heart are enlarged. Chest X-rays can help find other lung or heart conditions that may be causing the problems.

    Exercise testing: Your doctor may want you to run on a treadmill or ride a stationary bike while you are hooked up to a monitor, so he can see any changes in your oxygen levels, heart function, or other things.

    Your doctor may also do blood tests to check for HIV and conditions like rheumatoid arthritis or lupus.

    If these tests show that you might have pulmonary hypertension, your doctor will need to do a right heart catheterization to be sure. Here's what happens during that test:

    • The doctor places a catheter into a large vein, most often the jugular vein in your neck, and then threads it into the right side of your heart.
    • A monitor records the pressures in the right side of the heart and in the pulmonary arteries.
    • The doctor may also inject medicines into the catheter to see if the pulmonary arteries are stiff. This is called a vasoreactivity test.

    Right heart catheterization is safe. The doctor will give you a sedative and use local anesthesia. You can usually go home the same day, although you will need someone to drive you home.

    Questions for Your Doctor

    You may want to write down a list of questions before your appointment, so you can make sure you ask your doctor everything you want to. It can also help to have a friend or family member with you to help you get the answers you want.

    Some possible questions are:

    • What's the best treatment for me?
    • How often should I see a doctor for my condition?
    • Do I need to see a specialist?
    • When should I go to the emergency room?
    • Do I need to limit the salt or fluids in my diet?
    • What kind of exercise can I do?
    • Are there any activities I should stay away from?
    • Should I get a pneumonia vaccine and a flu shot?

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