• shortness of breath with mild exertion
• undue fatigue
• chest pain or pressure
• dizzy spells and fainting

These symptoms are non-specific, and can occur with other diseases, or even in normal people. In many cases, your pediatrician, family doctor, or internist can determine that pulmonary hypertension is or is not involved, but sometimes consultation with a specialist is required.

An echocardiogram (a test which uses sound waves to determine and structure and function of the heart) will sometimes, but not always, give an accurate estimate of pulmonary artery pressure. It is also useful for estimating right ventricular function and function of the heart's valves, which is important for patients with pulmonary hypertension. This test is painless, takes about 30 minutes, and is easily performed in the doctor's office. Children below the age of about 3 years sometimes require sedation for this test.

Cardiac catheterization is the most accurate way to measure pulmonary artery pressure and other important variables. With this test, a small diameter tube ("catheter") is passed into a vein and guided into the heart using x-rays. Pressure inside the heart, and oxygen levels of the blood are measured. Injection of a liquid which shows up on x-ray shows the structure of the pulmonary arteries. The response of pulmonary artery pressure to certain medications can also be determined. Cardiac catheterization is done with the patient sedated. In some cases, this test can be performed without requiring hospitalization, but in others an overnight hospital stay is required.

Other tests may provide valuable information regarding the cause of the pulmonary hypertension, and the effect that the increased pressure is having on the heart:

• Blood Testing -- This may help identify the cause of the pulmonary hypertension, and certain problems caused by the pulmonary hypertension.

• Electrocardiogram ("ECG" or "EKG") -- A test that records the electrical activity of the heart, shows abnormal rhythms, and detects heart muscle stress or enlargement.

• Chest x-ray -- This test shows the size and shape of the heart, and can show certain abnormalities of the lungs.

• CT scan of the chest -- This test shows the lungs in more detail than a chest x-ray, and is better in detecting certain problems than a chest x-ray.

• Cardiac MRI -- This test shows the structure and function of the heart using a different type of technology than x-rays. It provides more accurate information regarding right ventricular size and function than echocardiography.

• Pulmonary Function Testing -- These tests measure breathing and lung capacity.

• Exercise tests (on a cycle, treadmill, or walking) -- allow us to measure how pulmonary hypertension affects the body's ability to exercise.

• Ventilation and perfusion scans -- These tests use a very weakly radioactive material, inhaled or injected into a vein in the arm, to determine where air and blood flow within the lungs.