11th May 2025

A 39-year-old female initially presented with increasing breathlessness on exertion and exertional dizziness and fatigue.

A 39-year-old female initially presented with increasing breathlessness on exertion and exertional dizziness and fatigue. She has no past medical history. Examination and subsequent investigations confirm a diagnosis of pulmonary hypertension, and no secondary causes are found. She has been referred to a specialist pulmonary hypertension centre, where vasodilator testing is performed. Mean pulmonary arterial pressures at the start of the study were 51mmHg, following inhalation of nitric oxide, pulmonary arterial pressures were 39mmHg and cardiac output remained unchanged throughout. Given these findings, which of the following is the most appropriate medical intervention?

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