MRCP2-0133

MRCP2-0133

A 25-year-old man from a travelling family presents to the Emergency department after experiencing a fainting episode. He reports having multiple fainting attacks and increased shortness of breath with minimal exercise over the past few months. Upon examination, his BP is 150/85 mmHg, pulse is 80 and regular, and he is short of breath at rest. The following investigations were conducted: Haemoglobin 137 g/L (135-177), White cell count 6.7 ×109/L (4-11), Platelets 203 ×109/L (150-400), Sodium 138 mmol/L (135-146), Potassium 4.0 mmol/L (3.5-5), Creatinine 112 µmol/L (79-118), Pulmonary artery systolic pressure estimated at 85 mmHg, and O2 saturation 89% descending aorta, 99% ascending aorta. What is the most likely diagnosis?