*If unable to obtain a reliable test in a young child and there is a high index of suspicion for underlying lung disease, the patient may require further lung imaging.
**Children older than 7 years of age can usually perform reliably to assess exercise tolerance with cardiopulmonary exercise testing in conjunction with diagnostic work-up. The 6-minute walk test may be less useful in many children. Reproduced with permission from (69).
Figure 2: Diagnostic algorithm in children with suspected PH.