The Silent Burden: Pulmonary Hypertension in Tuberculosis Patients

India is one of the highest tuberculosis (TB) burden countries in the world, contributing to almost a quarter of TB cases globally. Post-TB lung diseases contribute significantly to TB disease burden, with almost half of disability adjusted life years (DALYs) lost attributable to post-TB sequelae. Pulmonary hypertension (PH) has been the most under-recognized complication of TB, although studies have shown that almost half the patients with post-TB disease have PH and have a poor prognosis and increased mortality. Chest physicians in India have been seeing PH and cor pulmonale in TB and post-TB patients in their clinical practice for a long time, but TB has not yet been acknowledged as an etiology for PH in the literature. Considering the high burden of TB in India, it is imperative that TB–PH be recognized as a unique entity so that early diagnosis through screening and management through appropriate therapy can be initiated, preventing young lives from being crippled and lost.