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17th May 2025
An 85-year-old female is admitted with increased breathlessness and ankle oedema for 4 weeks.
An 85-year-old female is admitted with increased breathlessness and ankle oedema for 4 weeks. She usually uses Fostair 100/6 1 puff twice daily and salbutamol inhalers when required for her asthma. Her blood pressure is 128/70, heart rate 146 and oxygen saturation is 98% on room air.
Investigations:
| Haemoglobin | 135 g/L (130–180) |
| White cell count | 8.0 × 109/L (4.0–11.0) |
| Platelet count | 296 × 109/L (150–400) |
| CRP | 5 (<2) |
| Serum sodium | 140 mmol/L (137–144) |
| Serum potassium | 3.6 mmol/L (3.5–4.9) |
| Serum urea | 3.0 mmol/L (2.5–7.0) |
| Serum creatinine | 125 μmol/L (60–110) |
| Serum magnesium | 0.96 mmol/L (0.85-1.10) |
| NT-proBNP | 420 (<450 pg/mL) |
| D-dimer | 0.31 (<0.50) |
What is the most appropriate next step in management?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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