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A 55-year-old man presents to his physician’s office with increasing dyspnea on exertion. He denies chest pain, diaphoresis, nausea, or vomiting. He has been involved in eight motor vehicle accidents in the past 3 years. Past medical history is significant for hypertension, for which he takes a diuretic. His temperature is 37.2°C (99.0°F), blood pressure is 121/82 mm Hg, pulse is 85/min, respiratory rate is 14/min, and oxygen saturation is 99% on room air. Physical examination is significant for diffuse and laterally displaced point of maximal intensity and an S3 gallop. Which of the following is the most appropriate next step in diagnosis?
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