In a patient with history of chronic bronchitis and suspected cor pulmonale, what abnormal physical finding might be expected on examination?

In a patient with chronic bronchitis, especially one with suspected cor pulmonale, the presence of signs of right-sided heart failure is a critical physical finding during examination. Cor pulmonale refers to right heart failure that occurs as a result of primary lung disease, most commonly due to chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis.

When the lungs are chronically diseased, they can cause increased pressure in the pulmonary circulation (pulmonary hypertension), leading to right ventricular overload and ultimately right-sided heart failure. Signs of right-sided heart failure include jugular venous distention, hepatomegaly, and ascites. These findings indicate that the right side of the heart is struggling to effectively pump blood, leading to backflow and congestion in systemic circulation.

Other options may present in pulmonary conditions but do not directly address the anticipated findings in a case of chronic bronchitis with cor pulmonale. Lower extremity edema may occur, but it's often secondary to right-sided heart failure rather than a standalone examination finding associated with chronic bronchitis itself. Increased lung sounds might be observed in different respiratory conditions but do not typically correlate with cor pulmonale. Pulmonary nodules are not a common finding in chronic bronchitis and are more indicative of