<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 77-year-old male presents to the emergency department because of shortness of breath and chest discomfort. The patient states his ability to withstand activity has steadily declined, and most recently he has been unable to climb more than one flight of stairs without having to stop to catch his breath. On physical exam, the patient has a harsh crescendo-decrescendo systolic murmur heard over the right sternal boarder, with radiation to his carotids. Which of the following additional findings are most likely in this patient?? A: A wide and fixed split S2, B: A constant, machine-like murmur heard between the scapulae, C: A paradoxically split S2, D: A diastolic murmur heard at the cardiac apex, E: A high-bitched, blowing, holosystolic murmur,  <response>: This is a patient with symptoms of dyspnea on exertion and chest discomfort, along with a harsh systolic murmur on exam. The key physical exam finding is the crescendo-decrescendo systolic murmur heard at the right sternal border and radiating to the carotids. This description is classic for aortic stenosis. Aortic stenosis causes obstruction to left ventricular outflow, leading to gradually increasing symptoms with exertion. Additional exam findings in aortic stenosis would include a delayed and diminished carotid upstroke pulsus parvus et tardus. Of the choices given, a paradoxical splitting of S2 would be most consistent with aortic stenosis, as the aortic component is delayed due to the obstructed left ventricular outflow.C: A paradoxically split S2 