New Paroxysmal Nocturnal Dyspnea in Medicine / Internal Medicine — 58yo Man | Cardiology | SMLE Q#11667
SMLE Question #11667
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 58-year-old man has 3 months of progressive exertional dyspnea with new paroxysmal nocturnal dyspnea and orthopnea. He has long-standing hypertension and type 2 diabetes mellitus and reports occasional exertional chest tightness relieved by rest. Examination shows bibasilar crackles and mild bilateral pedal edema. Transthoracic echocardiography shows a left ventricular ejection fraction of 30% with regional wall-motion abnormality. Which of the following is the next best investigation?
Continue in practice mode
Sign in and start a focused practice session to view options, submit your answer, and read the full explanation.