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One of the most noteworthy updates in pulmonary hypertension (PH) are the new hemodynamic definitions of PH. Previously, PH was defined by a resting mean pulmonary arterial pressure (mPAP) threshold of 25mmHg during right heart catheterization. At the 6th World Symposium on Pulmonary Hypertension in Nice, France in 2018, the hemodynamic definition of PH was changed to a threshold mPAP> 20mmHg. This change was based on observations that the upper limit of normal for resting mPAP in adults is 20mmHg, and that “borderline” elevation of mPAP (21-24mmHg) is associated with significant morbidity and mortality in several patient populations. 1–3 However, mPAP> 20mmHg is not sufficient to define pulmonary vascular disease as it can be caused by high cardiac output or high left atrial or pulmonary arterial wedge pressure (group 2PH). The new definitions thus delineate pre-capillary, post …