ESC/ERS guidelines: probability of pulmonary arterial hypertension (PAH) diagnosis and suggested management according to the echocardiographic diagnosis of pulmonary hypertension (PH) (table 8), symptoms and additional clinical information
| Low probability for PAH diagnosis | Class# | Level¶ |
| Echocardiographic diagnosis of “PH unlikely”, no symptoms: no additional work-up is recommended | I | C |
| Echocardiographic diagnosis of “PH unlikely”, presence of symptoms and of associated conditions or risk factors for group 1–PAH: echocardiographic follow-up is recommended | I | C |
| Echocardiographic diagnosis of “PH unlikely”, presence of symptoms and absence of associated conditions or risk factors for group 1–PAH: evaluation of other causes for the symptoms is recommended | I | C |
| Intermediate probability for PAH | ||
| Echocardiographic diagnosis of “PH possible”, no symptoms and absence of associated conditions or risk factors for group 1–PAH: echo- cardiographic follow-up is recommended | I | C |
| Echocardiographic diagnosis of “PH possible”, presence of symptoms and of associated conditions or risk factors for group 1–PAH: RHC may be considered | IIb | C |
| Echocardiographic diagnosis of “PH possible”, presence of symptoms and absence of associated conditions or risk factors for group 1–PAH: alternative diagnosis and echocardiographic follow-up may be considered. If symptoms at least moderate RHC may be considered | IIb | C |
| High probability for PAH | ||
| Echocardiographic diagnosis of “PH likely”, with symptoms and presence/absence of associated conditions or risk factors for group 1–PAH: RHC is recommended | I | C |
| Echocardiographic diagnosis of “PH likely”, without symptoms and presence/absence of associated conditions or risks factors for group 1–PAH: RHC should be considered | IIa | C |
RHC: right heart catheterisation. #: class of recommendation; ¶: level of evidence. Reproduced from 1 with permission from the publisher.