30th April 2024

A 65-year-old woman with a history of hypertension and type 2 diabetes mellitus presents to the clinic complaining of increasing fatigue, shortness of breath on exertion, and swollen ankles over the past few weeks.

A 65-year-old woman with a history of hypertension and type 2 diabetes mellitus presents to the clinic complaining of increasing fatigue, shortness of breath on exertion, and swollen ankles over the past few weeks. She denies chest pain. Her medications include metformin, amlodipine, and a thiazide diuretic. On examination, her blood pressure is 145/90 mmHg, heart rate is 88 bpm, and there are crackles at the lung bases. Her jugular venous pressure is elevated, and there is 2+ pitting edema in the ankles.

Which is the most appropriate diagnostic investigation?