5th May 2025

An 80-year-old man is admitted to the Emergency Department with worsening breathless and peripheral oedema over several weeks.

An 80-year-old man is admitted to the Emergency Department with worsening breathless and peripheral oedema over several weeks. He has post-ischaemic cardiomyopathy and atrial fibrillation and is optimised on medication. His medication includes digoxin 125 mcg once daily, bisoprolol 5mg once daily, furosemide 40mg twice a day, apixaban 5 mg twice daily and ramipril 10mg once daily. On examination his heart rate is 40 bpm and irregular, BP is 90/76, there is peripheral oedema to above the knee and an elevated JVP. He has bibasal crepitations. On questioning, he complains of a yellow tinge to his vision. What is the most appropriate immediate management option for this patient?

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