Resolu？？o do "shunt" direita-esquerda após uso do sildenafil como tratamento de hipertens？o pulmonar primária

primary pulmonary hypertension is a rare, progressive disease with high mortality rates. the treatment of primary pulmonary hypertension is still based on high-cost drugs, not yet available in developing countries. recently, the use of sildenafil as an alternative drug for primary pulmonary hypertension treatment has been reported. it is reported a case of a 21 year-old female patient with primary pulmonary hypertension, who presented an acute worsening of symptoms and decrease of oxygen saturation. the investigation revealed the existence of a patent oval foramen not previously seen, with right-to-left shunt. sildenafil treatment was instituted in escalating doses. after 40 days of treatment, the echocardiogram showed resolution of the shunt, concomitant to oxygenation improvement. the authors believe that sildenafil is a feasible alternative for primary pulmonary hypertension treatment, although larger clinical trials are necessary to determine its clinical safety and efficacy.