<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 43-year-old woman presents to her primary care provider with shortness of breath. She reports a 4-month history of progressively worsening difficulty breathing with associated occasional chest pain. She is a long-distance runner but has had trouble running recently due to her breathing difficulties. Her past medical history is notable for well-controlled hypertension for which she takes hydrochlorothiazide. She had a tibial osteosarcoma lesion with pulmonary metastases as a child and successfully underwent chemotherapy and surgical resection. She has a 10 pack-year smoking history but quit 15 years ago. She drinks a glass of wine 3 times per week. Her temperature is 98.6F 37C, blood pressure is 14085 mmHg, pulse is 82min, and respirations are 18min. On exam, she has increased work of breathing with a normal S1 and loud P2. An echocardiogram in this patient would most likely reveal which of the following?? A: Biventricular dilatation with a decreased ejection fraction, B: Left atrial dilatation with mitral valve stenosis, C: Left ventricular dilatation with an incompetent aortic valve, D: Left ventricular hypertrophy with a bicuspid aortic valve, E: Right ventricular hypertrophy with a dilated pulmonary artery,  <response>: This is a patient with progressive shortness of breath and chest pain. Key points from the history include a childhood history of osteosarcoma with pulmonary metastases treated with chemo and surgery, hypertension, and a smoking history. The physical exam shows signs of increased work of breathing and a loud P2 heart sound. The childhood cancer history with lung metastases suggests the possibility of pulmonary hypertension leading to right heart changes. Hypertension can also cause left ventricular hypertrophy. The loud P2 indicates pulmonary hypertension. Therefore, the likely echocardiogram finding is right ventricular hypertrophy with a dilated pulmonary artery, choice E.E: Right ventricular hypertrophy with a dilated pulmonary artery 