Challenges in the management of pulmonary hypertension manifested during pregnancy: Case report

Pulmonary hypertension (PH) during pregnancy is a highly complex clinical entity. It is estimated to affect 1.1 out of every 100,000 pregnancies, generating a high maternal mortality which is close to 50% according to the severity of presentation; however, with appropriate treatment, mortality can be reduced by 15-30%. This paper presents the case of a female patient in the second decade of life with severe PH, initially attributed to congenital heart disease, and later associated with systemic lupus erythematosus (SLE). The clinical evolution required escalation of pharmacological therapy to triple therapy, achieving improvement in quality of life and functional capacity. Diagnostic challenges during pregnancy, the need for multidisciplinary approaches, and the importance of adequate risk stratification are discussed. Current guidelines recommend initial triple therapy in patients with high-risk PAH, supported by evidence demonstrating its impact on survival. This case underscores the importance of early intervention, individualized management, and cross-specialty coordination to optimize clinical outcomes in the high-risk setting