23rd September 2021

A 17-year-old male presents to his GP with a persistent headache and exertional dyspnoea

A 17-year-old male presents to his GP with a persistent headache and exertional dyspnoea, which has been ongoing over the last few months. He has no past medical or family history. Of note on examination, there is a systolic murmur heard in the interscapular region and a difference in systolic blood pressure of 30 between the arms and legs. He is referred to secondary care 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.