ischaemic heart disease and left ventricular dysfunction with dyspnoea.. Pulsus alternans

A 72-year-old man who has a history of ischaemic heart disease and left ventricular dysfunction is admitted with dyspnoea. He has not taken his diuretics for three days as he ran out. On examination you note bilateral crackles to the midzones and a respiratory rate of 30/min. Which other clinical finding is most consistent with this presentation?
A.A Bisferiens pulse
B.A Wide pulse pressure
C.A Warm peripheries
D.A Pulsus alternans***
E.A Fourth heart sound (S4)
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