<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 7-year-old boy is brought by his parents to his pediatrician due to progressive fatigue and shortness of breath while playing sports. He is otherwise healthy with no known medical disorders and no other symptoms. The boy was born at 39 weeks gestation via spontaneous vaginal delivery. He is up to date on all vaccines and is meeting all developmental milestones. On physical examination, his temperature is 36.9oC 98.4oF, pulse rate is 90min, blood pressure is 10070 mm Hg, and respiratory rate is 18min. Pulses in all four extremities are equal and normally palpated; there is no radio-femoral delay. The pediatrician suspects a congenital heart disease after auscultation of the heart. Which of the following congenital heart diseases is most likely to present with the clinical features listed above?? A: Aortopulmonary window defect, B: Coarctation of the aorta, C: Complete atrioventricular septal defect, D: Atrial septal defect, E: Double-outlet right ventricle with subaortic ventricular septal defect,  <response>: Based on the information provided in the question stem, the patient is a 7-year-old boy with progressive fatigue and shortness of breath during physical activity, suggesting a congenital heart defect limiting his exercise capacity. The history of normal birth and development makes complex congenital heart diseases like complete AV septal defect or double outlet right ventricle less likely. The lack of a pulse differential or blood pressure difference between upper and lower extremities makes coarctation of the aorta unlikely. The most likely diagnosis given the nonspecific symptoms and lack of overt physical exam findings is an atrial septal defect, which can allow right to left shunting and decreased oxygen delivery during activity when right heart pressures are increased.D: Atrial septal defect 