Long-standing Asthma in Medicine / Internal Medicine — 45yo Woman | Cardiology | SMLE Q#11233
SMLE Question #11233
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 45-year-old woman with long-standing asthma and known moderate mitral regurgitation has 3 weeks of progressively worsening exertional dyspnea, now limited to one flight of stairs and not relieved by albuterol. Cardiac examination reveals a grade 3/6 holosystolic murmur at the apex radiating to the left axilla. Lungs are clear, and there is no peripheral edema. What is the most appropriate diagnostic test to obtain now?
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