Work

Group 5 Pulmonary Hypertension Resulting From Thyrotoxicosis During Pregnancy

Year: 2026

Type: article

Abstract: BACKGROUND: We present a case of uncontrolled hyperthyroidism during pregnancy associated with heart failure with preserved ejection fraction and pulmonary hypertension (pHTN). CASE SUMMARY: A 32-year-old woman at 22 weeks' gestation was nonadherent to hyperthyroid medications. She presented with shortness of breath and was found to have pHTN on transthoracic echocardiography. Right heart catheterization revealed post-capillary pHTN, an elevated pulmonary artery occlusion pressure (33 mm Hg), and high cardiac output, consistent with group 5 pHTN. She was managed with antithyroid medications, corticosteroids, and aggressive diuresis, and she continued the pregnancy. DISCUSSION: Pulmonary arterial hypertension is associated with right heart failure and is currently classified as modified World Health Organization class IV (pregnancy contraindicated). However, group 5 pHTN may be managed safely during pregnancy. TAKE-HOME MESSAGE: This case highlights that group 5 pHTN has a different cardiac risk profile compared with group 1 pulmonary arterial hypertension, and right heart catheterization was instrumental in stratifying this risk and counseling the patient.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106656

Authors: Rosa Drummond, Lisa Forbess, Allison Lankford

Institution: University of Maryland Medical Center

Language: English

Topic: Pulmonary Hypertension Research and Treatments

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850