Have you had an echocardiogram as part of your heart workup? An echo can show possible causes for SOB. One thing it sometimes shows is an indication of possible pulmonary hypertension. Pulmonary hypertension is difficult to diagnose because symptoms are so similar to so many things and because most people have one or more of those other things. Pulmonary hypertension is high blood pressure in the lungs. It is not the same thing as high blood pressure in the arm. Pulmonary hypertension has 5 types - the first of which is the worst; the last four are caused by something else (heart disease is most common cause). The only way to definitely diagnose or rule out pulmonary hypertension is by having a right heart catheterization. If you have PH doctors will treat the underlying cause if there is one, or the PH directly if appropriate. But the heart echo is a good screening tool to see if the right heart cath is even needed. It is non-invasive, quick, and easy.