原发性肺动脉高压80%见于妇女。作者报道1例27岁初孕妇,健康无心血管症状史,孕22周有呼吸困难,26周声音嘶哑,诊断为左侧喉返神经麻痹,呼吸困难恶化。孕30周时稍用力呼吸困难伴紫绀。血压100/60mmHg,颈静脉压升到10cm伴凸起的静脉波。临床有右室肥厚,胸部可闻第二音高调与第四心音,胸骨左边缘有全收缩期杂音伴三尖瓣反流。心电图证实窦性心律与右房和右室肥厚。胸X片显示心脏和主要的肺动脉轻度扩大,可能见于正常妊娠。应用三尖瓣反流高峰流量间接估价肺动脉收缩压在46mmHg。通气灌注证明在左上部位节段灌注缺陷伴肺栓塞,诊断为原发性肺动脉高 80% of primary pulmonary hypertension is seen in women. The authors reported a 27-year-old pregnant woman with no previous history of cardiovascular symptoms, breathing difficulties at 22 weeks of pregnancy, hoarseness at 26 weeks, diagnosis of paralysis of the left recurrent laryngeal nerve and worsening of dyspnea. 30 weeks pregnant hard breathing difficulty with cyanosis. Blood pressure 100 / 60mmHg, jugular vein pressure up to 10cm with raised venous waves. Clinical right ventricular hypertrophy, the second highest-pitching tone of the chest can be heard with the fourth heart sound, the left sternal edge of the systolic murmur with tricuspid regurgitation. Electrocardiogram confirmed sinus rhythm and right atrium and right ventricular hypertrophy. Chest X-ray showed a slight enlargement of the heart and major pulmonary arteries, which may be seen in normal pregnancy. Indirect assessment of pulmonary artery systolic pressure at 46 mmHg using tricuspid regurgitation peak flow. Ventilation perfusion demonstrated segmental perfusion defects in the upper left with pulmonary embolism and was diagnosed as primary pulmonary hypertension