Does everyone with pulmonary hypertension need a catheterization to measure pressures?

Yes and maybe: A catheterization will best determine what the exact pressure is (you can diagnosed pulmonary hypertension clinically though, i.e.: physical exam, ecg, cxr and echocardiography). Yet the most important info you get from a cath is whether the pressure responds to various medications available that can then be used a treatment for the elevated pulmonary pressures.

No: Only those with poorly controlled pulmonary hypertension with recurrent right sided heart failure should undergo a catheterization.

Heart cath: Pulmonary Arterial Hypertension cannot be diagnosed without a right sided heart catheterization. It's not all about pressure but is about flow produced by the heart, vascular resistance, as well as pressures in the heart chambers and vena cava.

Yes.: It's the only way to make the diagnosis.