A female with pulmonary artery hypertension and pleural effusion

A 42-year-old Caucasian female was admitted to hospital with a history of dyspnoea at rest. Apart from a history of nodular prurigo for which she used topical steroid creams, the patient was generally healthy. The patient reported that shortness of breath had started 3 months ago, initially on exertion, but now had progressed to dyspnoea at rest. In addition, the patient was experiencing orthopnoea and required four pillows at night. There was no history of chest pain, cough, wheeze, haemoptysis or expectoration of phlegm. However, there was a history of frequent and loose stools with non-specific abdominal discomfort over the same time period.