This ECG is from a 76 year old female with a grade 5/6 systolic murmur and blowing diastolic murmur similar to those reproduced here. Her blood pressure was 135/50. The systolic murmur was heard best in the 2nd right and left intercostal spaces, where a thrill was also palpated, and radiated into the neck. The diastolic murmur was heard best along the left sternal border. What is your interpretation?