The ECG shown here is from a 53 year old male with mild exertional dyspnea who recalled having had rheumatic fever when he was 14 years old. His blood pressure was 165/60 and there was a prominent apical impulse as well as systolic and diastolic murmurs similar to those shown here. The systolic murmur seemed to fill all of systole and was heard over the entire precordium while the decrescendo blowing diastolic murmur was best heard along the left sternal border. What is your interpretation of these findings?