16th February 2025

A 66-year-old lady with a BMI of 34 who uses home CPAP for obstructive sleep apnoea has a 6-month history of worsening fatigue, breathlessness and orthopnoea.

A 66-year-old lady with a BMI of 34 who uses home CPAP for obstructive sleep apnoea has a 6-month history of worsening fatigue, breathlessness and orthopnoea. She is an ex-smoker with a 30-pack-year history.

On examination, she has peripheral oedema to her knees and a loud second heart sound.

What is the most likely cause of her symptoms?

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