Figure it out fridays
47-year-old woman presented to the ER with dyspnea on exertion, otherwise vitally stable.
Her medical history was remarkable for asthma and ovarian cyst.
At regular health check-ups during her elementary school years, chest radiographs appeared abnormal; however, she never had any opportunities for further examinations until this presentation.
A cardiac catheterization study demonstrated elevated pulmonary capillary wedge pressure (31 mm Hg) and elevated pulmonary arterial pressure (53 mm Hg)
She underwent CXR and CT chest as shown above
What is your diagnosis?