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EasyCardiologyCongestive heart failure fluid overloadau-amcau-racp

A 58-year-old man presents with progressive exertional dyspnoea and ankle swelling. He has a history of ischaemic heart disease. Examination reveals bilateral pitting oedema to the mid-shins, an elevated JVP and bibasal crackles. Which of the following is the most appropriate initial diuretic therapy for symptomatic relief of fluid overload?

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