Evidence Checklist: Pulmonary Hypertension

Echocardiogram documenting elevated pulmonary artery pressureCritical

Transthoracic echocardiogram (TTE) estimating right ventricular systolic pressure (RVSP) as a non-invasive screen for pulmonary hypertension. An RVSP > 35-40 mmHg on echo prompts further evaluation.

Right heart catheterization (RHC) confirming mPAPCritical

Right heart catheterization is the definitive diagnostic test, documenting mean pulmonary artery pressure (mPAP >= 25 mmHg at rest defines PH) and pulmonary vascular resistance.

Nexus opinion linking pulmonary hypertension to service ("at least as likely as not")Critical

A medical opinion connecting your pulmonary hypertension to a service-connected condition such as sleep apnea, pulmonary embolism, COPD, or sarcoidosis, or to direct in-service inhalational exposures.

Pulmonary function tests (PFTs) with DLCO

PFTs including diffusion capacity to document any associated lung disease contributing to or resulting from pulmonary hypertension and to quantify functional impairment.

Six-minute walk test (6MWT) documenting exercise tolerance

Standardized functional test measuring exercise capacity. 6MWT distance is a validated measure of functional class in pulmonary hypertension and correlates with prognosis.

Treatment records (pulmonary vasodilators, oxygen, anticoagulation)

Records documenting PAH-specific therapy (phosphodiesterase inhibitors, endothelin receptor antagonists, prostacyclins), supplemental oxygen requirements, and anticoagulation.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Completed DBQ Respiratory ConditionsCritical

Standardized form capturing hemodynamic data, PFT values, exercise tolerance, and functional limitations from pulmonary hypertension.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.