Which post-mortem finding is the most dependable indicator of left-sided heart failure?

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Congestion in the systemic veinsSwelling of the lower limbsLong-term venous congestion within the lungsEnlargement of the liver and spleen

Explanation

Left-sided heart failure primarily causes blood to back up into the lungs, resulting in chronic venous congestion there. This makes chronic pulmonary venous congestion the most reliable post-mortem sign. Other features like systemic venous congestion or peripheral edema are more associated with right-sided heart failure.