19th February 2025

A patient with suspected pulmonary hypertension has undergone extensive work up and no underlying cause has been identified.

A patient with suspected pulmonary hypertension has undergone extensive work up and no underlying cause has been identified. They undergo right heart catheterisation which confirms a diagnosis of idiopathic pulmonary hypertension. Vasoreactivity testing is carried out at the same time and demonstrates a decrease in mean pulmonary artery pressure at rest from 42 to 30 mmHg with other parameters remaining stable. They are a WHO functional class II and deemed to be intermediate risk. Which medication would you consider starting first for this patient?

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