Question 1: Interpret the sitting and supine shunt values.

            In the supine position, the value of the blood pressure obtained was 666mmHg while in the sitting position the value of the blood pressure obtained was 670mmHg. From this data, it can be deduced that when the patient is in the supine position, there is the increase in the intraocular pressure (IOP) as compared to the value obtained when she is in the upright position. Therefore, in the sitting position, there is the obstruction of air in airways as compared when she is in the supine position. Moreover, the obstruction of airflow is the one that resulted to the fall in FEV (1.23 L).

            Question 2: What is the cause of the patient’s symptoms?

            From the historical data collected, smoking is one of the main causes of the patient’s symptoms.

            Question 3: What other tests might be indicated?

In order to ascertain whether the main cause of the patient’s symptoms was smoking, it is important to carry out other tests associated with dilated cardiomyopathy, hypertension, and ischemic heart disease.

            Question 4: On the basis of these findings, what treatment might be recommended?

            Other than liver transplant, there are various methods which can be used to enhance normal blood pressure in the patient. One the main treatment that can be recommended will entail engaging the patient in daily physical activities which will aid in ensuring that there is the reduction of the obstruction of airflow in airways. Another reason for that is because it has the ability of increasing the circulation of blood in the body.