<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 16-year-old male adolescent presents to his pediatrician with increasing fatigue and breathlessness with exercise. His parents inform the doctor that they have recently migrated from a developing country, where he was diagnosed as having a large ventricular septal defect VSD. However, due to their poor economic condition and scarce medical facilities, surgical repair was not performed in that country. The pediatrician explains to the parents that patients with large VSDs are at increased risk for several complications, including Eisenmenger syndrome. If the patient has developed this complication, he is not a good candidate for surgical closure of the defect. Which of the following clinical signs, if present on physical examination, would suggest the presence of this complication?? A: A loud first heart sound, B: A mid-diastolic low-pitched rumble at the apex, C: Right ventricular heave, D: Prominence of the left precordium, E: Lateral displacement of the apical impulse,  <response>: This is a medical question asking about the clinical signs that would suggest Eisenmenger syndrome, a complication of large ventricular septal defects VSDs. Eisenmenger syndrome involves increased pulmonary vascular resistance leading to reversal of the shunt through the VSD. The key is to identify signs of pulmonary hypertension that would occur with Eisenmenger syndrome.C: Right ventricular heave 