If you have a hole in your heart, between the two lower heart chambers, or ventricles, this is called Eisenmenger syndrome. This is a type of congenital heart disease which referrers to a ventricular septal defect in the heart and leads to PAH. The hole causes the blood to the heart to flow abnormally, or not circulate properly. This means the red blood cells, which carry oxygen) mix with the blue blood cells (oxygen-poor blood) and flows to the lungs instead of going to the rest of your body. This increases pressure greatly in the pulmonary arteries and causes PAH.

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