23rd September 2021

A 15-year-old male presents to his GP with exertional dyspnoea

A 15-year-old male presents to his GP with exertional dyspnoea, which had been ongoing over the last few months. He is no longer able to play sport. He has no past medical or family history. Of note on examination, there is a pansystolic murmur, best heard in the lower left sternal edge, as well as widely split first and second heart sounds. There is also hepatomegaly and ankle oedema. The GP refers him to cardiology for investigation.

Which of the following is the gold-standard investigation to evaluate the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.