<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 comes to the physician because of increasing shortness of breath for 1 month. Initially, he was able to climb the 3 flights of stairs to his apartment, but he now needs several breaks to catch his breath. He has no chest pain. He has rheumatic heart disease and type 2 diabetes mellitus. He emigrated from India about 25 years ago. The patients current medications include carvedilol, torsemide, and insulin. He appears uncomfortable. His temperature is 37.3C 99.1F, pulse is 72min and regular, respirations are 18min, and blood pressure is 13080 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 96. Examination shows bilateral crackles at the lung bases. There is an opening snap followed by a low-pitched diastolic murmur at the fifth left intercostal space at the mid-clavicular line. An x-ray of the chest shows left atrial enlargement, straightening of the left cardiac border and increased vascular markings. Which of the following is the preferred intervention to improve this patients symptoms?? A: Tricuspid valve repair, B: Mitral valve replacement, C: Percutaneous mitral balloon commissurotomy, D: Transcatheter aortic valve replacement, E: Enalapril therapyn,  <response>: Based on the information provided in the question stem, this patient has symptoms of worsening shortness of breath, a history of rheumatic heart disease and diabetes, and physical exam findings of a diastolic murmur and chest x-ray showing left atrial enlargement. This suggests the patient has mitral stenosis that has progressed, likely from his history of rheumatic heart disease. The choices provided include different valve interventions as well as medical therapy with an ACE inhibitor. Since the mitral stenosis seems to be the cause of his symptoms, an intervention to open up the narrowed mitral valve would be the preferred treatment. Of the options, percutaneous mitral balloon commissurotomy is the least invasive approach that can successfully open up a stenotic mitral valve. The other options do not specifically address the mitral stenosis.C: Percutaneous mitral balloon commissurotomy 