Diagnostic evaluation of suspected sarcoidosis-associated pulmonary hypertension

This algorithm provides a general overview of our approach to the diagnosis of PH in patients with sarcoidosis. In general, this population benefits from a multidisciplinary team approach that involves both sarcoidosis and PH experts. We consider the possibility of SAPH in patients with sarcoidosis who have dyspnea that is unexplained or disproportionately severe in comparison with imaging and PFTs, dyspnea that is persistent or severe despite anti-inflammatory therapy, new onset dyspnea associated with worsening New York Heart Association functional class, and/or manifestations of right heart failure (eg, exertional chest pain, syncope, lower extremity edema, increased abdominal girth due to ascites, loud pulmonic component of the second heart sound^¶). Refer to UpToDate topic on diagnosis of SAPH.