11th May 2025

A 49-year-old woman presents to accident and emergency with fatigue and shortness of breath of exertion, accompanied by chest pain and dizziness.

A 49-year-old woman presents to accident and emergency with fatigue and shortness of breath of exertion, accompanied by chest pain and dizziness. She has a past medical history of ischaemic heart disease, hypercholesterolaemia and asthma. She takes aspirin 75mg once daily, atorvastatin 80 mg once daily, bisoprolol 5mg once daily, ramipril 10mg once daily, Fostair 2 puffs twice daily and salmeterol 2 puffs twice daily. Chest x-ray shows no acute changes and a computed tomography pulmonary angiogram (CTPA) is performed. CTPA shows no evidence of occluded pulmonary vasculature but shows an enlarged proximal pulmonary artery with sudden narrowing, dilated right and left ventricles. You note the patient’s records show a recent echocardiogram revealing raised mean pulmonary pressures and bilateral systolic dysfunction. You suspect a diagnosis of pulmonary hypertension. Given the above findings, which of the following WHO groups is the underlying aetiology of her PH most likely classified into?

Select the SINGLE most appropriate option from the list below. Select ONE option only.