If your medical team suspects that you have chronic thromboembolic pulmonary hypertension (CTEPH), they will run a number of tests. The goals of these tests are to establish whether you have CTEPH or another type of PH. If you do have CTEPH, the first priority is to determine if you are a candidate for pulmonary thromboendartectomy (PTE) surgery.
Common tests include:
- Ventilation/Perfusion Scan (V/Q Scan). This test shows any areas in the lung that are not receiving the appropriate blood flow due to blockage of the arteries by clots.
- Echocardiogram. In this procedure, electrodes are placed on the patient’s skin and a sonogram of the heart is taken. This painless procedure is often used to make a preliminary diagnosis by estimating the pressures in the right heart and assessing how well the heart is functioning.
- Right-heart catheterization. Right-heart catheterization is the most accurate and useful test to get a definitive diagnosis of pulmonary hypertension.This test directly measures the pressure inside the pulmonary arteries, and it should be done in all patients at least once to confirm a patient’s diagnosis with PH. During the test, doctors insert a catheter (a thin rubber tube) through a large vein in the patient’s groin or neck. They then pass the catheter up into the patient’s heart to measure the blood pressure in the right side of the heart and lungs.
- Pulmonary angiogram. Like a right-heart catheterization, a catheter is placed through a vein in the neck (or groin) into the pulmonary arteries. This test is done by injecting dye into the arteries and taking pictures. This test will confirm if chronic blood clots are the cause of the patient’s pulmonary hypertension.
- Coronary angiogram. Patients who are deemed candidates for PTE surgery and are at risk for coronary artery disease will also undergo this test to see if they have significant coronary artery disease (blockages in the arteries that supply the heart muscle with blood and oxygen). If the doctors identify significant coronary artery disease, they will typically treat it during the PTE procedure.
- CT scan. Some patients undergo this test to look for blood clots and to evaluate the condition of the rest of the lung besides the arteries. If you get a CT scan, your veins will be injected with dye and photographed.