Suggest Treatment For Shortness Of Breath With History Of Left Upper Extremity Pain

A 70 year old woman presenting with 3 month history of L upper extremity pain after walking up 2 flight of stairs at home. Relieved with rest. She also reported shortness of breath, but denied CP, dizziness, syncope, vomiting or swelling. She awoke this morning and was baking for a friend s funeral and experienced the same symptoms. It lasted for 10 minutes. FH: mother died of stroke at 68, Father died of lung CA at 59. SIster had HTN, DM (67). Nn smoker, occasional wine drinker, babysits part time. meds HCTZ, ASA. EKG: SR with slight left deviation and Intraventricular conduction defect with a QRS interval of 0.10. T waves flat. Poor R wave progression. Please recommend 4 differential diagnois