I would like to know the following for my wife Asha Vasudeva, age 45 Yrs suffering from Pulmunory hypertension for the past 20 yrs. She was diagonised to have PH at 22 yrs after the delivery of a boy child. He is now 21 yrs old. Asha has been almost stable though she always had her good days & bad days For the past few days she always complaints of tiredness, weakness on leg, hands etc and is scared. She has been taking Penegra ( 25 mg) (1-0-1) and has started taking Lupibose 62.5 (1-0-1 ) for the past one month. What can be reason for the severe /sudden tiredness and how her health condition can be improved ?