You are incorrect - our patient's history is most consistent with cyanotic congenital heart disease.


Your choice: Idiopathic pulmonary arterial hypertension
Patients with idiopathic pulmonary arterial hypertension typically present with exercise intolerance that is slowly progressive over many years. Right heart failure may occur. They rarely manifest cyanosis, especially in childhood, and they do not demonstrate squatting. A significant heart murmur during childhood also is unusual.