Assignment Task: A 72 yr old man with a hx of peripheral vascular disease presents to the pcp c/o SOB for the last month, and now cannot climb 1 flight of stairs without severe SOB. On further questioning he states occ chest pain on heavy exertion says 1 week earlier he fainted after climbing the stairs from his basement. He has no hx of cardiac or lung disease except for the PVD and has no diabetes, no hx of smoking or high cholesterol. He has no fam hx of this either. On PE he is in No apparent distress. 98.6 12, 140/80 and 80, 99% on RA. There is a slow rise of the cardiac upstroke, a sustained apical impulse, and a quiet S2 as well as a 3/6 harsh systolic ejection murmur heard best at second ICS at the right sternal border. Explain the triad of symptoms he presents with. What is the diagnosis?
Also Give 3 Differential Diagnosis and rationale