Left Ventricular Ejection Fraction in Medicine / Internal Medicine — 58yo Man | Cardiology | SMLE Q#16971

SMLE Question #16971

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 58-year-old man has 4 months of progressive exertional dyspnea and paroxysmal nocturnal dyspnea. He has hypertension and hyperlipidaemia. Examination shows bibasilar crackles and mild bilateral ankle oedema. Transthoracic echocardiography shows anterior left ventricular regional hypokinesia with a left ventricular ejection fraction of 30%. He is being evaluated for an ischaemic aetiology and possible revascularisation. Which of the following is the most appropriate next investigation?

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