A 55 year old stock broker admits himself to Accident and Emergency complaining of several muscular pains, a shortness of breath and also unexplained weight loss. The man also shows signs of bleeding under his fingernails and broken blood vessels in the whites of his eyes. The man has had previous issues with his heart but no major surgery performed. Upon examination, the doctor listens to the mans heartbeat and reports a heart murmur. Given the information disclosed, which one of the following is a likely diagnosis?