75 year old man with shortness of breath with minimal exertion - Diagnosis

Patient Chart History: 75 year old man complains of shortness of breath with minimal exertion. Lips have a bluish tint.

Physical Exam
Blood pressure is normal.
Pulse rate is 95 bpm.
Occasional expiratory wheeze is noted.

Test Results: Normal thyroid function tests.
Failed six minute walking test.

Heart Sounds:

Diagnosis What is your diagnosis?

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Case #233