Preserved Systolic Function (ef in Medicine / Internal Medicine — 66yo Man | Cardiology | SMLE Q#10954
SMLE Question #10954
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 66-year-old man has 3 months of progressive exertional dyspnea worse when lying flat, bilateral leg swelling, and increasing abdominal distension. Examination shows raised jugular venous pressure, bilateral pitting edema, ascites, basal crackles, and tender hepatomegaly. Transthoracic echocardiography shows normal left and right ventricular size with preserved systolic function (EF >60%), marked biatrial enlargement, and no significant valvular disease. A restrictive filling process is suspected. What is the most useful next diagnostic test to help confirm the underlying cause?
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