<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 4-year-old male is brought into your office because his mother states he has been fatigued. He has not been acting like himself and has been getting tired easily while running around and playing with other children. As of last week, he has also been complaining of being short of breath. His vitals are temperature 98.6 deg F 37.2 deg C, blood pressure 10075 mmHg, pulse 98min, and respirations 22min. On exam, the patient is short of breath, and there is a holosystolic murmur with an appreciable thrill along the left sternal border. There are no other noticeable abnormalities, and the mother states that the childs prenatal course along with genetic testing was normal. What is the most likely diagnosis?? A: Endocardial cushion defect, B: Tetrology of Fallot, C: Patent ductus arteriosus PDA, D: Ventricular septal defect VSD, E: Atrial septal defect ASD,  <response>: This is a question about diagnosing a pediatric cardiac murmur. The key findings in the stem are: - 4 year old male with fatigue, shortness of breath, and holosystolic murmur- Murmur is along left sternal border with thrill - Normal prenatal course and genetic testingBased on the patients age, symptoms, and physical exam findings of a holosystolic murmur with thrill localized to the left sternal border, the most likely diagnosis is a ventricular septal defect VSD. VSDs are the most common congenital heart defect and often present with symptoms in early childhood. The holosystolic murmur is due to increased flow across the defect. The other answer choices can be ruled out based on the details provided.D: Ventricular septal defect VSD 