Primary Pulmonary Hypertension

You are incorrect - the most likely etiology of our patient's pulmonary hypertension is idiopathic pulmonary arterial hypertension.

Your choice: Mitral stenosis

Patients with severe mitral stenosis frequently develop pulmonary hypertension. These patients may also have a history of rheumatic fever. On cardiac examination, the findings may include an apical opening snap and a diastolic rumble that may be difficult to detect when the cardiac output is low.