ABSTRACT
Primary pulmonary hypertension [PPH] is a rare disease. The annual incidence is approximately 2 per million population. Although the onset may be at any age, symptomatic disease usually manifests between the ages of 30 and 36 years. In childhood, both sexes are equally affected; however, after puberty, females predominate. We present the case of a 28-year-old Hispanic woman who reported increasing dyspnea on exertion. The 2D echocardiogram showed right atrial and right ventricular enlargement with signs of pressure overload. The pulmonary pressures were elevated and higher than the systemic pressures suggesting Eisenmenger's syndrome. A patent foramen ovale was noted by echocardiography. The patient responded poorly to medical therapy and currently is on a waiting list for lung transplantation