Abstract
We present the case of a patient who developed severe pre-capillary pulmonary hypertension 7 years after heart transplantation. The transplantation was performed due to the dilated phase of hypertrophic cardiomyopathy with combined post- and pre-capillary pulmonary hypertension (CpcPH), which had initially improved. This case highlights the potential underlying factors contributing to pulmonary arterial hypertension in patients with CpcPH and the importance of careful long-term follow-up after heart transplantation.