The primary pathology of a condition is chronic pressure overload in the right ventricle developing from high blood pressure in the pulmonary artery. Which condition is it?

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This describes cor pulmonale—the right ventricle adapts to chronic high pressure in the pulmonary arteries. When the pulmonary vascular resistance stays elevated, the right ventricle must work harder to push blood through the lungs. Over time this causes right ventricular hypertrophy and, if the load persists, dilation and eventual failure. That’s why the scene fits a chronic pulmonary cause of right-heart strain.

The other conditions don’t fit this pattern. Left ventricular failure centers on the left side of the heart and often leads to pulmonary edema from backward failure, not a primary right-ventricular pressure overload. Coronary artery disease involves ischemia of the heart muscle, not a chronic pulmonary-driven issue. A pulmonary embolism can acutely heighten right-sided pressures but is typically an acute problem, not the chronic, progressive process described here.