3 Months Of Progressive in Medicine / Internal Medicine — 58yo Man | Cardiology | SMLE Q#19034

SMLE Question #19034

Medicine / Internal Medicine Cardiology

Objective: OBJ-IM-CARD-CHF-ISCHEMIC-WORKUP

Last updated: March 2026
A 58-year-old man presents with 3 months of progressive exertional dyspnea and paroxysmal nocturnal dyspnea. He denies fever and productive cough. He has long-standing hypertension and no previously diagnosed coronary artery disease. Transthoracic echocardiography shows anteroseptal regional wall motion abnormality and a left ventricular ejection fraction of 30%. What is the next best investigation to evaluate the likely underlying cause?

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