Idiopathic pulmonary arterial hypertension misdiagnosed as asthma

Idiopathic pulmonary arterial hypertension (IPAH) is a rare disorder that is progressive and often leads to right heart failure if left untreated. Because of the vague nature of symptoms at presentation, IPAH may take several months to diagnose. The most common presenting complaint in patients with IPAH is dyspnea with exertion, which is also commonly seen with asthma. This report describes an adult female with refractory exertional dyspnea who was diagnosed with asthma 2 years earlier but was ultimately diagnosed with IPAH. Exclusion of other etiologies is a necessity for refractory dyspnea in the setting of asthma.