# Challenges and Insights: Severe Acute Right Ventricular Dysfunction in Pulmonary Hypertension

## TL;DR

A 35-year-old woman with severe pulmonary hypertension experienced right ventricular failure and syncope, highlighting the challenges in managing this condition.

## Contribution

This case report presents an unusual and severe manifestation of pulmonary hypertension leading to right ventricular dysfunction.

## Key findings

- The patient exhibited severe pulmonary hypertension confirmed by echocardiography.
- Untreated PH led to cardiogenic shock due to right ventricular failure.
- The case emphasizes the need for early intervention to prevent decompensated RV failure.

## Abstract

Pulmonary hypertension (PH) is rarely a cause of syncope. We highlight an unusual presentation of pulmonary hypertension where management was a veritable challenge. We present a case report of a 35-year-old female with a history of stage 2 hypertension, polycystic ovarian syndrome, and obesity who presented to the hospital with a six-month history of progressive shortness of breath, lower extremity swelling, and recurrent syncope. Further evaluation with transthoracic echocardiography showed features consistent with severe pulmonary hypertension. This untreated severe pulmonary hypertension culminated in cardiogenic shock due to right ventricular (RV) failure. Successful care in this patient population entails preventing the acute downward spiral of decompensated right ventricular failure.