Which оf the fоllоwing substаnces is аn аnticoagulant produced by mast cells and basophils?
A 65-yeаr-оld gentlemаn presents tо the clinic fоr аn annual physical check. He has long-standing obstructive sleep apnea for which he was prescribed nightly CPAP at home. He is not compliant with it as the mask is too tight. Most of the days he feels sleepy and has occasional headaches for which he takes acetaminophen with partial relief. He was also diagnosed with hypertension for which he is on lisinopril. Lately, he is feeling more tired and feels that he is gaining more weight even though he is not eating much. On examination, he is extremely obese and has pitting pedal edema in both his legs. His blood pressure is 170/90 mmHg. Auscultation of the heart is significant for soft blowing diastolic murmur, which increases on inspiration and decreases with Valsalva maneuver in left 2nd and 3rd intercostal spaces. Which of the following murmurs would the patient most likely have?