I would get him out of the high kill shelter right now. Then I would get the dental work done. I have a feeling the teeth might be the cause of the heart problem and once the teeth are fixed he should have many more good years.
Do not accept the cat. You can't help them ALL. 
Accept the cat and get dental work done.
Accept the cat, get the ultrasound and then decide on the dental.
Accept the cat and just try to keep him comfortable.
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I would get him out of the high kill shelter right now. Then I would get the dental work done. I have a feeling the teeth might be the cause of the heart problem and once the teeth are fixed he should have many more good years.
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