MS-0170

MS-0170

A 75-year-old male presents to his GP with a four week history of shortness of breath when he walks for approximately two minutes on level ground. There is also an associated central chest pain which resolves when he rests. The pain is localised and does not radiate.

On examination, there were obvious signs of ankle and sacral pitting oedema. A left ventricular heave was palpated but the apex beat was not displaced. A systolic murmur was heard best at the second intercostal space just right of the sternum. This murmur also radiated to the carotid arteries.

Which investigation is most likely to confirm the underlying cause of his symptoms?