Rosh Internal Medicine Boost Practice Exam

Which diagnostic test is considered the gold standard for diagnosing pulmonary hypertension?

1. Echocardiogram

2. Right heart catheterization

3. Pulmonary function test

4. CT pulmonary angiogram

The correct answer is: Right heart catheterization

Right heart catheterization is considered the gold standard for diagnosing pulmonary hypertension because it directly measures the pressures in the right atrium, right ventricle, and pulmonary artery. This procedure provides precise hemodynamic assessments that are crucial for an accurate diagnosis of pulmonary hypertension. It allows clinicians to assess the mean pulmonary artery pressure and evaluate the response to various therapeutic interventions, which is essential for determining the severity and potential treatment options for the condition. In contrast, while echocardiograms can suggest the presence of pulmonary hypertension by estimating pressures indirectly, they are not definitive diagnostic tools. Pulmonary function tests and CT pulmonary angiograms do not provide direct measurements of pulmonary artery pressures and are typically used to assess other aspects of lung function or to rule out other conditions rather than establishing a diagnosis of pulmonary hypertension.