A patient has dull right upper quadrant pain, jugular venous distention, and right ventricular hypertrophy on echocardiography. What is the most likely diagnosis?

The presence of dull right upper quadrant pain, jugular venous distention, and right ventricular hypertrophy on echocardiography suggests a diagnosis of cor pulmonale. Cor pulmonale refers to the alteration of the structure and function of the right ventricle caused by a primary disorder of the respiratory system.

In this context, the symptoms of right upper quadrant pain can be attributed to hepatic congestion due to elevated pressures in the right heart, which can occur as a consequence of cor pulmonale. Jugular venous distention indicates increased central venous pressure, often seen in cases where the right ventricle is unable to handle the volume of blood returning to it, which complements the findings of right ventricular hypertrophy. The echocardiographic finding of right ventricular hypertrophy indicates that the right ventricle is working harder than normal, often as a response to chronic pressure overload, which is consistent with cor pulmonale.

This diagnosis aligns well with the clinical picture presented, where there is a clear indication of right heart strain due to an underlying pulmonary process that affects the right ventricle's ability to function effectively.