25th July 2024

A 65-year-old man presents to A&E with a history of dyspnoea. On examination you notice

A 65-year-old man presents to A&E with a history of dyspnoea. On examination you notice he is short of breath on exertion, his skin is pale with some bruising and petechiae on his arms, and he has conjunctival pallor.

On cardiovascular examination you find him to have a heart rate of 115 bpm with a systolic murmur. Respiratory examination is normal.

What would be your first line investigation likely to aid in the diagnosis?

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