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A patient presents to the emergency department with weight loss, petechiae, and splinter hemorrhages. the patient's vital signs are: blood pressure 135/82, pulse 108, oxygen saturation 96%, on room air, and temperature 101.4° f. upon physical assessment, a new murmur is noted. what diagnostic test should be done first?

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With the salient features of the case including weight loss, petechiae, and splinter hemorrhages and PE findings of fever and increased BP and tachycardia; the primary assessment will be infective endocarditis. The hallmark for endocarditis is the presence of vegetations on the valves. These vegetations can be primarily visualized by 2D echocardiography. 
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