Pulmonary heart disease (PHD) encompasses conditions affecting the right side of the heart due to lung disorders or elevated pressure in the pulmonary arteries.1 Diseases of pulmonary circulation encompass pulmonary hypertension, pulmonary embolism, chronic thromboembolic pulmonary hypertension (CTEPH), and other disorders characterized by impaired blood flow through the lungs and the resulting strain on the right side of the heart and eventually right heart failure, Cor Pulmonale.2 Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure ≥25 mm Hg at rest, measured during right heart catheterization.3 Several common risk factors contribute to the development of pulmonary heart disease and diseases of pulmonary circulation. These include smoking, environmental pollutants, obesity, and underlying medical conditions such as COPD and congenital heart defects, which contribute to the development of pulmonary heart disease and diseases of pulmonary circulation.4 Pulmonary arterial hypertension (PAH) arises from a complex interplay of genetic and environmental factors, triggering an imbalance within the pulmonary vasculature. This cascade leads to vasoconstriction, abnormal proliferation of endothelial and smooth muscle cells, inflammation, vascular remodeling, and thrombosis, ultimately causing increased pulmonary vascular resistance (PVR) and characteristic clinical symptoms.5 Notably, PAH-associated remodeling encompasses not just the entire vessel wall, but also involves diverse cell populations within each layer. Endothelial cells, smooth muscle cells, fibroblasts, inflammatory cells, and platelets all play significant roles in this pathological process, contributing to the intricate pathophysiology of PAH.6 A range of diagnostic methods are used to evaluate and diagnose pulmonary heart disease and diseases of pulmonary circulation, like Diagnostic strategies for acute presentation of pulmonary hypertension in children particularly focusing on use of echocardiography, cardiac catheterization, magnetic resonance imaging, pulmonary function tests, chest computed tomography, lung biopsy and biomarkers like brain natriuretic peptide (BNP) levels.7 Right heart catheterization remains the gold standard for the hemodynamic evaluation of pulmonary circulation, furnishing critical insights into both the differential diagnosis and the severity of pulmonary hypertension.8 Pulmonary heart disease and diseases of pulmonary circulation, along with heart failure and chronic obstructive pulmonary disease (COPD), are significant public health challenges with far-reaching impacts on healthcare systems, economies, and population health.9 These conditions contribute to increased healthcare utilization, including hospitalizations, outpatient visits, and interventions, leading to substantial direct and indirect costs.10 They also have a significant impact on morbidity, mortality, and overall healthcare costs.11 Globally, pulmonary vascular diseases present diverse prevalence patterns. Pulmonary hypertension (PH), affecting an estimated 1% of the global population which increases up to 10% in individuals aged more than 65 years, exemplifies this heterogeneity and contributes significantly to morbidity and mortality.12 Pulmonary embolism (PE) is a sudden blockage of one or more arteries in the lungs, typically caused by a blood clot traveling from elsewhere in the body, often from the legs. This obstruction can lead to serious complications such as difficulty breathing, chest pain, and, in severe cases, death. Similarly, acute pulmonary embolism has an estimated incidence ranging from 60 to 120 per 100,000 people per year, with approximately 60,000 to 100,000 patients dying from pulmonary embolism each year in the US.13 Given these different factors that can be associated with Pulmonary heart diseases and diseases of pulmonary circulation and also agents or substances that can cause it and its associated conditions, it is necessary to find a pattern in causation and associated conditions. Therefore, both demographic trends and mortality trends are examined.