I am a 38-year-old male recently diagnosed with Chronic Ischaemic Heart Disease. My recent laboratory results show very high triglyceride levels at 563 mg/dL and total cholesterol at 249 mg/dL. Although I do not currently have chest pain, I have been experiencing palpitations and shortness of breath while running or talking 10 miniutes, sometimes accompanied by syncope. I am currently prescribed LIPANTHYL (Fenofibrate) 145 mg and ASTATIN (Atorvastatin) 10 mg. Since my insurance has not approved further investigations, could you please advise if an echocardiogram is strictly required for my condition or if there are alternative steps I should take?