11th July 2023

A 58-year-old lady feels that her nails have not grown over the last 8 months

A 58-year-old lady feels that her nails have not grown over the last 8 months. She gets mildly breathless on exertion but is otherwise well. Examination of the cardiorespiratory system and abdomen reveals bilateral ankle oedema but no other abnormalities. Her nails appear mildly discoloured and thick.

What is the most appropriate initial investigation?

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