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Answer 3
  1. Echocardiogram. Of the tests listed, the one that would provide the most information in this patient is echocardiography.1 This test allows assessment of the size and function of the heart chambers, the morphology and function of the heart valves, congenital anomalies, and diastolic function. Echocardiography also allows hemodynamic estimates of stroke volume, pulmonary artery pressure, right atrial pressure, and left atrial pressure (a surrogate for left ventricular diastolic pressure). General practitioners underutilize this modality and often do not evaluate left ventricular function in patients with a diagnosis of CHF.

     Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines, 2001. Available at http://www.acc.org/clinical/guidelines/failure/hf_index.htm. Accessed 21 April 2003.

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