<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 49-year-old man is referred to a cardiologist by his primary care provider PCP for a new heart murmur. He otherwise feels well and has no complaints. He had not seen a doctor in the last 15 years but finally went to his PCP for a check-up at the urging of his girlfriend. His past medical history is notable for gastroesophageal reflux disease, hypertension, and hepatitis B. He takes omeprazole and lisinopril. He has a prior history of intravenous drug abuse and a 50-pack-year smoking history. He has had many prior sexual partners and uses protection intermittently. He reports that he may have had a sore on his penis many years ago, but it went away without treatment. His temperature is 99F 37.2C, blood pressure is 14191 mmHg, pulse is 89min, and respirations are 18min. On exam, S1 is normal and S2 has a tambour-like quality. There is a visible and palpable pulsation in the suprasternal notch and a diastolic decrescendo murmur over the right upper sternal border. A chest radiograph demonstrates calcification of the aortic root. Which of the following is the most likely cause of this patients condition?? A: Fibrinous plaque formation in the arterial intima, B: Neoplastic growth in the cardiac atria, C: Pericardial inflammation, D: Tricuspid valve inflammation, E: Vasa vasorum destruction,  <response>: This is a clinical case scenario about a 49-year-old man with a new heart murmur. The key findings in the stem are:- New heart murmur on exam - Visible and palpable pulsation in the suprasternal notch- Diastolic decrescendo murmur over the right upper sternal border- Chest x-ray showing aortic root calcificationBased on these findings, the most likely diagnosis is aortic regurgitation due to damageinfection of the aortic valve. Choices A and E relate to atherosclerosisvasculitis which would not cause a new murmur. Choice B about neoplastic growth in the atria is unlikely with no other symptoms.Choice C about pericarditis would cause a friction rub, not a murmur.Choice D about tricuspid valve inflammation could cause a murmur but is not supported by the location and radiation of this murmur.Therefore, the most likely cause is damage to the aortic valve itself, likely from prior endocarditis given his risk factors.E: Vasa vasorum destruction 