A 65-year-old male with long-standing hypertension complains of progressive breathlessness on exertion over the last few months. On examination, there are signs of left ventricular hypertrophy and a gallop rhythm. What is the likely diagnosis, and what are the next steps?
This patient's symptoms and examination findings suggest heart failure, potentially due to hypertensive heart disease with left ventricular hypertrophy. Further evaluation should include an EKG, chest X-ray, and echocardiogram to evaluate heart structure and function. Blood tests should include a complete blood count, metabolic panel, lipid profile, and NT-proBNP. Management involves controlling blood pressure, managing fluid status, and potentially starting medications like ACE inhibitors, beta-blockers, and diuretics based on the results.