MRCP2-0531

MRCP2-0531

A 45-year-old man presents to the hospital with a two-week history of flu-like symptoms, wheezing, shortness of breath when lying flat, and palpitations. He has no significant medical history. His vital signs include a heart rate of 98 beats per minute, blood pressure of 96/50 mmHg, and oxygen saturation of 96% on 2 liters of oxygen. He has no fever.

Upon examination, the patient has a low volume pulse with a raised jugular venous pressure and a raised Y descent. A third heart sound is audible, but there are no murmurs. Bilateral crepitations and pitting edema of the legs are present.

Blood tests reveal a hemoglobin level of 158 g/L, platelet count of 335 * 109/L, white blood cell count of 11.7 * 109/L, and elevated neutrophils, lymphocytes, and eosinophils. Electrolyte levels are within normal limits, and the C-reactive protein level is elevated.

The patient’s ECG shows sinus rhythm with left ventricular hypertrophy but no signs of ischemia. The PR interval is normal. An echocardiogram reveals preserved systolic function with moderate concentric left ventricular hypertrophy, dilated atria, and evidence of diastolic dysfunction. There is no valvular pathology or suspicious lesions surrounding the valves.

In this case, what imaging modality would be most appropriate for identifying the patient’s diagnosis?