Table 12—

Probability of pulmonary arterial hypertension(PAH) diagnosis and suggested management according to the echocardiographic diagnosis of pulmonary hypertension (PH; table 9), symptoms and additional clinical information

Low probability for PAH diagnosisClass#Level
 Echocardiographic diagnosis of “PH unlikely”, no symptoms: no additional work-up is recommendedIC
 Echocardiographic diagnosis of “PH unlikely”, presence of symptoms and of associated conditions or risks factors for group1–PAH: echocardiographic follow-up is recommendedIC
 Echocardiographic diagnosis of “PH unlikely”, presence of symptoms and absence of associated conditions or risks factors for group 1–PAH: evaluation of other causes for the symptoms is recommendedIC
Intermediate probability for PAH
 Echocardiographic diagnosis of “PH possible”, no symptoms and absence of associated conditions or risks factors for group 1–PAH: echocardiographic follow-up is recommendedIC
 Echocardiographic diagnosis of “PH possible”, presence of symptoms and of associated conditions or risks factors for group 1–PAH: RHC may be consideredIIbC
 Echocardiographic diagnosis of “PH possible”, presence of symptoms and absence of associated conditions or risks factors for group 1–PAH: alternative diagnosis and echocardiographic follow-up may be considered. If symptoms at least moderate RHC may be consideredIIbC
High probability for PAH
 Echocardiographic diagnosis of “PH likely”, with symptoms and presence/absence of associated conditions or risks factors for group 1–PAH: RHC is recommendedIC
 Echocardiographic diagnosis of “PH likely”, without symptoms and presence/absence of associated conditions or risks factors for group 1–PAH: RHC should be consideredIIaC
  • RHC: right heart catheterisation. #: class of recommendation; : level of evidence.