hello management of pulmonary arterial hypertension depends on the cause of PAH. have you undergone relevant investigations for the evaluation ? what is the echocardiography report? has v/q scan or CT chest been done ? because the management differs according to cause. since you have told pulmonary arterial hypertension I suppose all other causes have been excluded. in such case how symptomatic are you? if your symptoms are mild to moderate then sildenafil, bosentan are good options. in case of more severe symptoms intravenous or inhaled prostaglandins should be started. combination therapy depends on the symptomatic stage and respono above drugs. if you have any more specific questions I will be happy to answer thank you