<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 35-year-old woman presents to the ER with shortness of breath, cough, and severe lower limb enlargement. The dyspnea was of sudden onset, started a week ago, and increased with exercise but did not disappear with rest. Her cough was dry, persistent, and non-productive. She has a family history of maternal hypertension. Her vital signs include heart rate 106min, respiratory rate 28min, and blood pressure 14090 mm Hg. On physical examination, thoracic expansion was diminished on the right side with rhonchi and crackles on the lower two-thirds of both sides, with left predominance. A systolic murmur was heard on the tricuspid foci, which increased in intensity with inspiration. There was jugular engorgement when the bed was placed at 50. Palpation of the abdomen was painful on the right hypochondrium, with hepatomegaly 4 cm below the lower coastal edge. Hepatojugular reflux was present. Soft, painless, pitting edema was present in both lower limbs up until the middle third of both legs. Lung computed tomography CT and transthoracic echocardiogram were performed and detected right heart failure and severe pulmonary fibrosis. What is the most likely diagnosis?? A: Left-sided heart failure, B: Coronary artery disease, C: Liver disease, D: Budd-chiari syndrome, E: Cor pulmonale,  <response>: Based on the information provided in the question stem, the key findings are:- Shortness of breath, cough, and lower limb swelling - suggests respiratory andor cardiac involvement- Sudden onset dyspnea that worsens with exercise - suggests heart failure - Nonproductive cough - suggests pulmonary disease rather than infection- Family history of hypertension - raises risk of cardiac issues- Vital signs show tachycardia and hypertension - supports cardiac involvement - Diminished thoracic expansion, rhonchicrackles, louder murmur on inspiration - suggests lung disease- Jugular venous distension, hepatomegaly, hepatojugular reflux - signs of right heart failure- Bilateral lower limb edema - suggests right heart failure given distribution- CT and echo showing right heart failure and pulmonary fibrosis - confirms lung and right heart involvementThe key aspect is the right heart failure with severe pulmonary fibrosis. This matches most closely with cor pulmonale, which is right ventricular enlargement secondary to lung disease. The pulmonary fibrosis has caused increased pulmonary vascular resistance and pulmonary hypertension, leading to right ventricular overload and failure.E: Cor pulmonale 