Left Ventricular Ejection Fraction in Medicine / Internal Medicine — 58yo Man | Cardiology | SMLE Q#17583

SMLE Question #17583

Medicine / Internal Medicine Cardiology

Objective: OBJ-IM-CARD-ISCHEMIC-CM-INVEST

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 and reports intermittent exertional chest tightness for 1 year. Examination shows bibasilar crackles and an S3 gallop. Transthoracic echocardiography shows anterior wall hypokinesia with a left ventricular ejection fraction of 30%. Which of the following is the next best investigation?

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