11th May 2025

A 65-year-old man with COPD presents to general practice complaining of increased abdominal distention and swelling in the ankles over the last 5-months.

A 65-year-old man with COPD presents to general practice complaining of increased abdominal distention and swelling in the ankles over the last 5-months. He has severe COPD and continues to smoke. Examination reveals a raised JVP, loud P2 and pedal oedema. You suspect he may have developed Cor Pulmonale. What is the most appropriate first-line investigation to aid your clinical suspicion of pulmonary hypertension? 

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