A 75 yr old man with Marfan’s

A 75 yr old man with Marfan’s syndrome presents to his PCP c/o SOB over the past 6 months. He says his exercise tolerance has gradually decreased from ten blocks on level ground to about one block, and is limited by SOB. Also he has SOB at night with generalized fatigue, occ palpitations, and feels like his heart is “pounding” esp when he lies on his left side. On PE he is in NAD and appears very tall [6′ 7, and thin – 162 lbs]. 98.6, 160/50 80 12 O2 sat = 99 on RA. He has a laterally displaced point of maximum impulse, distant HSs, a high pitched early diastolic murmur heard best at the left sternal border that is decreased by Valsalva maneuver,[ EXPLAIN THIS] clear lungs, and peripheral pulses with sharp upstrokes and downstrokes. [EXPLAIN THIS]. What is the diagnosis? Give 3 DIFFS WITH RATIONALES = SCIENCE HEALTH SCIENCE NURSING NURSING 7642

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