Novak B. is now 68 years old. He comes to the office today complaining of shortness of breath and fatigue on exertion. While Novak B. denies chest pain, over the last 3-4 weeks he has been getting more short of breath. He first noticed this when he was playing golf with his friends a few weeks ago. He wasn't able to finish his 18-hole game, despite using a cart. He walks his dog about 1 km every evening and usually stops every 250 m due to leg cramps. Lately, however, he has needed to stop every 100 m due to leg cramps as well as at the half-way mark due to fatigue. For the last week, he has been increasingly sleeping in his recliner rather than his bed due to difficulty breathing; however, he denies waking up gasping for air when you ask. He is still struggling with a burning sensation in his feet and legs and wakes up at night to “shake it off”. His once thin legs are becoming increasingly swollen as the day progresses. He denies any cough, fever or night sweats. He feels his heart is running faster at times, especially when physically active. You know that his spouse passed away last year after a long battle with cancer. He has 2 children who live out West. When questioned about alcohol intake, he admits that he has been drinking more alcohol since his spouse passed away.