Last Week's Answer

Congratulations to Max for getting the correct answer on last week’s question.

Correct Answer: The picture showed pretibial myxedema or thyroid dermopathy, characterized as localized thickening of skin typically on the pretibial area, associated with Grave’s disease

This Week's Question

Correct answer (first after 4 PM on Friday) gets $5 to Starbucks!

A 58 year-old female presents with progressive dyspnea on exertion. Her physical exam finding is shown below. What is next best diagnostic step?