The 35-year-old, with chief complaint of dyspnea on exercise, cough, and fever for 2 days. The blood gas show PH: 70404, PCO2:32.2, PO2:59.1, HCO3:19.7, TCO2:20.7, BE: -3.9, %SO2: 90.1. The laboratory shows WBC: 19500, Hb: 12.3 gm% , Hct: 36.6%, Seg: 90, CRP: 59.73; CK: 180, CK-MB: 5.4, Troponin I : 0.06. Physical examination: crepitate rales on mid-lung to bases, no wheezes; regular rhythm, rapid heart beats, grade 4/6 systolic murmur over aortic area.

The chest roentgenogram and cardiac echo as below :

  根據以上影像及臨床表徵,您的臆測是什麼?