MRCP2-0349

MRCP2-0349

A 65-year-old woman arrives at the emergency department complaining of breathlessness. She has been experiencing increasing shortness of breath for the past two weeks, with a significant decrease in her ability to exercise. She now finds that even walking a few steps leaves her feeling breathless, whereas previously she could walk to her local shops and back without issue. She is unable to lie down as it exacerbates her symptoms. Her medical history includes hypertension, a previous heart attack, and asthma.

Upon examination, her JVP is elevated, and there are bilateral crepitations on auscultation. Air entry is reduced in both lung bases, and percussion is dull. Her chest X-ray reveals evidence of pulmonary edema and bilateral pleural effusions. What is the most appropriate course of action?