Natural selection can lead to adaptations that have both positive and negative effects due to the influence of various environmental factors and the timing of those effects in relation to reproduction. In this context, the best response would be:
The positive effects outweigh the negative effects in certain environments.
This response indicates that in specific environments, the advantages provided by an enlarged right ventricle (such as increased oxygen intake and enhanced performance in activities requiring endurance) can be significant enough to offset the risks of pulmonary hypertension that may arise later. If the organism can reproduce successfully before the negative effects manifest or if those effects can be mitigated by environmental factors, natural selection may favor this trait despite its drawbacks.