METHODS: Sequential patients undergoing right heart catheterization (RHC) at the PH clinic in Calgary, Canada were prospectively enrolled. A respirologist with PH experience examined each patient within 1 hour of RHC. Examiners were blinded to indication for RHC and diagnosis. Examiners determined presence or absence of physical examination signs: high jugular venous pressure (JVP) > 4cm, cV wave, palpable P2, parasternal heave, abdominal-jugular reflex (AJR), loud P2, P2 louder than A2 (P2>A2), right-sided S3, right-sided S4, pitting edema, tricuspid regurgitation and extra-physiologic splitting of S2. Examiner findings were compared to RHC to determine the sensitivity (Sn), specificity (Sp), positive (+LR) and negative likelihood ratio (-LR) with a threshold mPAP ≥ 35 to define moderate-to-severe PH.