This descriptive article details the elements of the right heart catheterization (RHC) that patients in the PVDOMICS Program undergo to evaluate the hemodynamics consistently and describes the details of the basic RHC and the three provocative tests used in patients with abnormal baseline results.

The provocative tests include oxygen/inhaled nitric oxide challenges, volume infusion challenges, and invasive cardiopulmonary stress tests.

The article also describes the methods, indications, and contraindications to these tests.

The authors also provide recommendations for promoting consistency in the hemodynamic measurements and reporting these findings, for example, which phase of the respiratory cycle to make measurements.

Overall, this article provides a concise review of the complete invasive hemodynamic assessment of patients with pulmonary hypertension.

It will prove helpful both for practicing physicians as well as trainees.  

All editors: B. Rush Waller, III, MD, FSCAI