# Resistant Secondary Hypertension and Severe Pulmonary Hypertension in a Young Adult due to a Rare Cause

## TL;DR

A rare congenital heart condition called Shone's complex can cause severe hypertension and heart issues in young adults, requiring careful diagnosis and multidisciplinary care.

## Contribution

Highlights the importance of considering congenital heart defects in young adults with unexplained cardiopulmonary symptoms and refractory hypertension.

## Key findings

- Shone's complex can present with resistant secondary hypertension and severe pulmonary hypertension in young adults.
- Multidisciplinary management is essential for patients with congenital defects and acquired cardiovascular adaptations.
- Clinicians should suspect congenital substrates in cases of unexplained cardiopulmonary deterioration.

## Abstract

Shone's complex (SC), a rare congenital cardiovascular malformation featuring multilevel left‐sided obstructive lesions, presents particular diagnostic challenges in adult populations. The complex interplay between congenital anatomical defects and acquired cardiovascular adaptations in adult SC patients requires multidisciplinary management. Clinicians must maintain a high suspicion for congenital substrates when evaluating young adults with unexplained cardiopulmonary deterioration, particularly when accompanied by refractory hypertension, severe pulmonary hypertension (PH), and right ventricular dysfunction.