A 65-year-old woman presents to the emergency department with shortness of breath, fatigue and increasing abdominal girth. On examination, she has ascites and tender hepatomegaly. Abdominal tapping is performed and reveals a serum-ascites albumin gradient (SAAG) of 18g/L. What is the single most likely diagnosis?

A. Spontaneous bacterial peritonitis

B. Ovarian cancer

C. Alcoholic liver disease

D. Heart failure

E. Hepatic vein thrombosis

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