5th May 2025

Mrs Smith is a 71-year-old female with known ischaemic heart disease, hypertension and hypercholesterolemia.

Mrs Smith is a 71-year-old female with known ischaemic heart disease, hypertension and hypercholesterolemia. On a routine review with her GP, she was noted to have a slow heart rate at 52 beats per minute. On asking about her daily activities, Mrs Smith tells the GP that she has found herself feeling slightly shorter of breath than usual and has not been walking as much as she normally does due to her shoes feeling tighter than usual. She also feels like she has gained some unintentional weight. You notice she is wearing a thick jumper in the clinic room. Clinical examination at the GP practice revealed ankle swelling. A resting 12-lead ECG in clinic reveals sinus bradycardia. You notice bloods done at her last review 6-months ago were unremarkable. What is the next most appropriate step in management of her condition?

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