5th April 2024

A 61-year-old occupational therapist presents to his GP with symptoms of polydipsia and leg cramps

A 61-year-old occupational therapist presents to his GP with symptoms of polydipsia and leg cramps that have been getting progressively worse over the last twelve months. The patient has a BMI of 34 and has suffered two myocardial infarctions in the past five years, the most recent of which happened eighteen months ago. He had an echocardiogram around that time, which showed an ejection fraction of 35%. His regular medications include atorvastatin and furosemide.

Initial investigations are as follows:

BP: 162/92 mmHg

Na+ 145 (135-145) mmols/L

K+ 2.5 (3.5-4.5) mmols/L

Creatinine 160 (59-104) mmols/L

What would be the next investigation into this patient to confirm the cause of his symptoms?

Select the SINGLE most appropriate option from the list below. Select ONE option only.