55 year with dyspnea on exertion, fatigue, nausea and sometimes epigastric pain, trouble breathing at night. Patient feels okay when he lies at back or sits. Vital signs BP 180/110, pulse 88 resp= 20 temp 98.0. What are 3 possible differential diagnosis? what tests are needed ? What treatments are appropriate for the patient? patient has ankles swollen after 3 months? what is the cause for the swollen ankles?