A 16-yr old girl with chronic pulmonary hypertension presents with hoarseness of voice for 4 months' duration. Above is the view of her larynx through a flexible naso-pharyngo-laryngoscope and an accompanying chest X-ray.
Q1: Describe the abnormalities seen.
Q2: What is the diagnosis based on the laryngeal appearance?
Q3: From the chest X-ray, what do you think is the cause for this pathology?