A 43-Year-Old Man Comes to the Office Due to Frequent

A 43-year-old man comes to the office due to frequent epigastric burning not relieved by antacids for the past 4 months.  The sensation is typically brought on by heavy lifting at work and takes 10-15 minutes to go away.  The patient has had no associated arm or neck pain, cough, shortness of breath, or difficulty swallowing.  His medical history is significant for systemic lupus erythematosus diagnosed 5 years ago, for which he takes low-dose prednisone and hydroxychloroquine.  He is a lifetime nonsmoker.  A year ago, the patient's wife was diagnosed with peptic ulcer disease that required treatment with antibiotics.  On physical examination, blood pressure is 140/90 mm Hg and pulse is 80/min and regular.  Breath sounds are equal on both sides.  No wheezes or crackles are heard.  First and second heart sounds are present.  No heart murmurs or rubs are noted.  The abdomen is soft and nontender to deep palpation.  There is no skin rash or peripheral edema.  ECG is normal.  Which of the following is the best next step in management of this patient?

A) Abdominal CT scan with/without contrast
B) Abdominal ultrasound
C) Chest CT scan without contrast
D) Coronary angiography
E) Echocardiogram
F) Esophageal motility studies
G) Exercise ECG
H) Stool Helicobacter pylori antigen testing
I) Upper gastrointestinal endoscopy