Dyspnea and lower extremity edema

A patient presents with complaint of dyspnea and lower extremity edema.

His Chest X ray is pictured below.  Labs reveal a BNP of 1000 otherwise CBC, Chemistry, Magnesium, Calcium, Phosphorous are all normal.  Medications include Procardia, and Metoprolol both prescribed for hypertension.  No other medical or surgical history.  PE: reveals bibasilar crackles and expiratory wheeze.  What differential diagnoses should be considered? Are there any ethical issues for discussion? Please provide your rationale.  Please respond to at least two peers.  Remember to provide evidence based resources.