A 66-year-old retired carpenter presents with chronic shortness of breath upon exertion. He has smoked a pack of cigarettes per day for the past 5 years and drinks alcohol regularly. On physical examination, a displaced point of maximal impulse and hepatosplenomegaly are noted. His medications include pantoprazole for gastroesophageal reflux and sertraline for depression. Echocardiogram reveals an ejection fraction of 30% and dilated left and right ventricles. Laboratory test results are:
Na+ 129 mmol/L
K+ 5.2 mmol/L
Cl- 101 mmol/L
Blood urea nitrogen 45 mg/dL
Creatinine 1.3 mg/dL
Glucose 134 mg/dL
Aspartate aminotransferase 220 U/L
Alanine aminotransferase 140 U/L
Alkaline phosphatase 280 U/L
Question：
1.What is the most likely diagnosis?
2.How to differential diagnosis with dilated cardiomyopathy?
3.What is the most appropiate treatment?
译文：
本次病例的患者为一名66岁的退休木匠，患者的主要表现为慢性劳力性呼吸困难。在过去5年里，该患者有每天一包烟的吸烟史，以及规律的饮酒史。患者在体检中发现心尖搏动点移位，以及肝脾肿大。用药史方面，患者服用治疗胃食道反流的泮托拉唑和治疗抑郁症的舍曲林。入院检查，心超显示射血分数为30%，双心室扩张。实验室检查结果如下：Na+ 129 mmol/L，K+ 5.2 mmol/L，Cl- 101 mmol/L，尿素氮（BUN）45 mg/dL，肌酐 1.3 mg/dL，血糖 134 mg/dL，AST 谷草220 U/L，ALT 谷丙140 U/L，碱性磷酸酶 280 U/L。
问题
1、根据上述病情，患者最可能的诊断是什么？
2、该疾病与扩张型心肌病如何鉴别？
3、该疾病最适合治疗方案是什么？
