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EasyCardiologyRight-sided heart failureca-mccqe1ca-rcpsc-im

A 65-year-old man with COPD and hypertension presents with a 2-week history of progressive lower extremity oedema and abdominal distension. Examination reveals elevated JVP, hepatomegaly and bilateral pitting oedema. ECG shows atrial fibrillation. What is the most likely cause of his symptoms?

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