Pulmonary hypertension symptoms are similar to other pulmonary diseases which increases the challenge of differential diagnosis. Shortness of breath and exertional fatigue are the most common subjective complaints. Many of the nonspecific subjective and objective findings of Pulmonary hypertension resemble those of heart failure thereby making a complete history and physical exam by the NP paramount. The NP must work in unison with the other members of the healthcare team to accurately diagnose Pulmonary hypertension.