What is the role of cardiac catheterization in the workup of idiopathic pulmonary arterial hypertension (IPAH)?

Updated: Jul 08, 2020
  • Author: Ronald J Oudiz, MD, FACP, FACC, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Right heart catheterization is the criterion standard test to definitively confirm any form of PAH, including IPAH. However, it must be understood that a thorough workup for suspected IPAH includes a range of tests to exclude all reasonable causes of PH. Excluding left-sided heart disease (including diastolic dysfunction) with catheterization is especially important in these patients because of major treatment implications (see Catheter Placement for Long-term Therapy). Catheterization is also performed to determine pulmonary vasoreactivity, which may have implications in the initiation and titration of high-dose calcium channel blocker (CCB) therapy. The initiation of intravenous therapy with prostacyclin analogues requires placement of a central venous catheter and detailed instruction on the long-term use of PAH-specific therapy.


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