6th May 2024

A 68-year-old woman with a history of congestive heart failure presents with shortness of breath and decreased exercise tolerance.

A 68-year-old woman with a history of congestive heart failure presents with shortness of breath and decreased exercise tolerance. On examination, she has bilateral ankle oedema and reduced breath sounds at the bases of both lungs. A chest X-ray shows bilateral pleural effusions. Echocardiogram confirms worsening left ventricular function.

Investigation:

Chest X-ray: Bilateral pleural effusions.

Echocardiogram: Reduced left ventricular function.

What is the most appropriate initial management for this patient’s pleural effusion?