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The question
After three days of IV furosemide, first 80 mg twice daily and then a continuous infusion, a man with HFrEF admitted with anasarca still has gross oedema; his weight has not changed and spot urine sodium is low. BP is 118/72 mmHg, creatinine is stable at 1.5 mg/dL, sodium 136 mmol/L and potassium 4.1 mmol/L. He is on bisoprolol and dapagliflozin as well. Which addition is most appropriate?
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