ABSTRACT
Right heart catheterisation (RHC) is the gold standard investigation for diagnosis of pulmonary arterial hypertension and to differentiate this condition from other forms of pulmonary hypertension (PH). RHC includes determination of resting pulmonary arterial and wedge pressures, cardiac output, presence and quantification of intra-cardiac shunting and assessment of acute pulmonary vasodilator reserve. The information obtained from RHC provides a guide to the likely prognosis, initial therapy and assessment of response to this therapy. Recent data suggest that exercise and fluid challenges during RHC may be useful manoeuvres to consider in addition to the resting haemodynamic study to further evaluate a breathless patient.
