19th February 2025

A 59-year-old woman with recurrent pulmonary emboli secondary to Factor V Leiden disease presents with chronic worsening exertional dyspnoea and bilateral leg swelling.

Difficulty Level: Moderate

A 59-year-old woman with recurrent pulmonary emboli secondary to Factor V Leiden disease presents with chronic worsening exertional dyspnoea and bilateral leg swelling. She undergoes investigation and a diagnosis of pulmonary hypertension is made secondary to chronic thromboembolic disease. In terms of symptoms, she is WHO functional class II. She also has a background of hypertension. What would be the first line management for this patient?

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