Cardiac catheterization in pulmonary arterial hypertension: Tips and tricks to enhance diagnosis and guide therapy

Cardiac catheterization (CC) is essential for the diagnosis of pulmonary hypertension (PH), and for its characterisation. It allows distinction between pre- and post-capillary PH which, when integrated with other non-invasive data, facilitates classification into one of the 5 diagnostic groups defined by international PH guidelines. CC also provides valuable information for the risk stratification of patients with PH, guiding management and the type and intensity of treatment. Right heart catheterization is usually sufficient in PH practice, yet additional information can be acquired by extending the protocol to include left heart catheterization or provocation protocols.

This review provides a detailed overview of diagnostic CC as used in PH practice, including in patients with congenital heart disease, with an emphasis on fundamental concepts, tips and tricks and potential pitfalls.