Screening and Diagnosis of Pulmonary Arterial Hypertension. Comments Regarding the Latest Guidelines from the European Societies of Cardiology and of Pulmonology

Transthoracic echocardiogram is the best tool for the screening of PH. When PH is suspected, the diagnosis must be confirmed by a right heart catheterization, and a vasoreactivity testing with NO must be performed in all cases of pulmonary arterial hypertension. Next steps for the work-up include: defining the type of PH (precapillary or postcapillary) and etiology, assessing prognostic factors, initiating therapy (if required) and following up the patient (particularly response to therapy). Routine screening is warranted in systemic sclerosis, HIV infection and portal hypertension. All patients with PH must be referred to a reference or a competence center for PH.