Abnormal elevation in pulmonary arterial blood pressure without secondary causes is Idiopathic Pulmonary Arterial Hypertension (IPAH). It is imperative to establish this diagnosis because IPAH often progresses to right heart failure (RHF) and death without treatment. Right heart catheterization is the standard gold test for diagnosing pulmonary hypertension (PH); however, echocardiography is a susceptible sensitive test and the best non-invasive test. The overall management of IPAH involves supportive measures, conventional therapy, and, pending availability, PAH-targeted therapy. Upon review of the literature, there were no published case reports on IPAH in Trinidad and Tobago. We describe a case of IPAH presented at Apley Medical Centre Limited, Trinidad and Tobago, in the West Indies, emphasizing contemporary management, including using the Implantable Delivery Systems (IDS) for Remodulin injection.

Datura, a wild-growing annual plant, common in the American Southwest and the Caribbean, has many uses, including medicinal or pharmaceutical, ornamental, religious, and social. In the Caribbean, this white trumpet-shaped flower has been used for many cultural aspects and has also been found to be used as a potent psychological stimulant. Despite its many purposes, its inappropriate misuse can result in mild-tosevere toxicity, leading to severe anticholinergic effects and even death in some cases. The purpose of this report is to highlight the toxic effects of this plant when misused and the subsequent management as it relates to the spectrum of anticholinergic poisoning, a common complication of drug overdose. We describe a case of datura poisoning presenting in Trinidad, West Indies, which was not described previously in the literature.

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