<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 55-year-old man is brought to the emergency department 30 minutes after the sudden onset of severe, migrating anterior chest pain, shortness of breath, and sweating at rest. He has hypertension, hypercholesterolemia, and type 2 diabetes mellitus. Medications include atorvastatin, hydrochlorothiazide, lisinopril, and metformin. He has smoked one pack of cigarettes daily for 25 years. He is in severe distress. His pulse is 110min, respirations are 20min, and blood pressure is 15085 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 98. Cardiac examination shows a grade 36, high-pitched, blowing, diastolic murmur heard best over the right sternal border. The lungs are clear to auscultation. Femoral pulses are decreased bilaterally. An ECG shows sinus tachycardia and left ventricular hypertrophy. Which of the following is the most likely diagnosis?? A: Pulmonary embolism, B: Esophageal rupture, C: Aortic dissection, D: Spontaneous pneumothorax, E: Papillary muscle rupture,  <response>: Based on the description, this is likely a case of acute chest pain in a middle-aged man with multiple cardiac risk factors. The key findings are sudden onset severe chest pain radiating to the back, associated with shortness of breath and sweating, suggesting an acute cardiac event. The diastolic murmur and decreased femoral pulses point towards aortic dissection as the likely diagnosis. The ECG showing sinus tachycardia and LVH are nonspecific but may be seen in aortic dissection. Pulmonary embolism, esophageal rupture, pneumothorax and papillary muscle rupture are less likely based on the clinical picture.C: Aortic dissection 