<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:One week after an aortic valve replacement surgery, a 55-year-old man is brought to the emergency room 30 minutes after the onset of severe, sharp chest pain. He appears pale and dyspneic but is alert, oriented, and speaks in full sentences. His temperature is 38C 100.4F, pulse is 192min and thready, respirations are 22min, and blood pressure is 8050 mm Hg. Faint rales can be heard in the lower lung fields on both sides on auscultation. There is a midline thoracotomy scar with mild reddening but without warmth or discharge. A portion of an ECG is shown. The pattern remains unchanged after 1 minute. Which of the following is the most appropriate intervention?? A: Epinephrine, B: Synchronized cardioversion, C: Vagal maneuvers, D: Administer magnesium sulfate, E: Administer amiodarone,  <response>: This is a patient who recently underwent aortic valve replacement surgery and now presents with chest pain, tachycardia, hypotension, fever, and lung crackles concerning for endocarditis and sepsis. The ECG shows a regular wide complex tachycardia concerning for ventricular tachycardia. The most appropriate immediate intervention is synchronized cardioversion to terminate the ventricular tachycardia and improve hemodynamics. Epinephrine may increase myocardial oxygen demand. Vagal maneuvers are unlikely to terminate ventricular tachycardia. Magnesium and amiodarone are not first line treatments for unstable ventricular tachycardia.B: Synchronized cardioversion 