MRCP2-0516

MRCP2-0516

A 38-year-old woman presents to the Emergency department with chest pain and rapidly worsening shortness of breath that has been occurring over the past 48 hours. She has a history of joint symptoms and has been diagnosed with systemic lupus erythematosus (SLE) by rheumatologists. There is no recent travel or signs of infection.

Upon examination, the patient has a respiratory rate of 26 and oxygen saturation of 97% on room air. Her pulse is 130 and blood pressure is 80/60 mmHg. The venous pressure is elevated, but there is no peripheral edema. Cardiac examination is unremarkable, and a 12-lead ECG shows only sinus tachycardia. A chest x-ray reveals a slightly enlarged heart but clear lung fields.

What is the most appropriate next step in managing this patient?