The patient receiving bosentan for pulmonary arterial hypertension is at an increased risk for fluid retention and heart failure both due to the nature of the disease and the medication. This may lead to the patient’s symptom of dyspnea. The most important assessment of heart failure and fluid retention for the patient with dyspnea is jugular venous distention (JVD), because this alerts the provider to right ventricular failure and is the best indicator provided for worsening pulmonary hypertension. Although the patient’s weight and peripheral edema may speak to the patient’s fluid overload, JVD provides a clearer picture. The patient’s blood pressure is also an important measurement, but less so than JVD.