Echocardiographic analysis of 57 Colombian adults with sickle cell disease revealed that while most maintained preserved heart function (median ejection fraction 63%), nearly 30% showed tricuspid regurgitation velocity exceeding 2.5 m/s, indicating intermediate-to-high probability of pulmonary hypertension. The cohort was relatively young (median age 24) with 76% having the severe SS genotype and 71% receiving hydroxyurea therapy. This finding adds crucial Latin American data to the global understanding of sickle cell cardiovascular complications. The high prevalence of subclinical pulmonary hypertension markers in young patients suggests cardiovascular screening should begin earlier than traditionally recommended. Pulmonary hypertension represents one of the leading causes of mortality in sickle cell disease, making early detection through accessible echocardiography potentially life-saving. The preserved biventricular function in most patients indicates a window for preventive interventions before irreversible damage occurs. However, this preprint awaits peer review, and the small sample size from a single center limits generalizability. These preliminary findings support routine echocardiographic screening as a cost-effective cardiovascular risk stratification tool, particularly valuable in resource-limited settings where advanced imaging may be unavailable.