Soru

A $74$-year-old woman presents to the emergency department with severe, sudden-onset shortness of breath that began $2$ hours ago. She has a history of type 2 diabetes mellitus, essential hypertension, and a $40$-pack-year smoking history. Current medications include amlodipine, metformin, and atorvastatin. Her temperature is $37.1^\circ\text{C}$ ($98.8^\circ\text{F}$), blood pressure is $185/105\text{ mmHg}$, pulse is $112\text{/min}$, and respirations are $28\text{/min}$. Pulse oximetry shows $88\%$ on room air. The patient appears anxious, diaphoretic, and is sitting upright. Physical examination reveals prominent jugular venous distention. Lung auscultation demonstrates diffuse expiratory wheezing bilaterally with crackles at the lung bases. Cardiac auscultation reveals a regular tachycardia with a prominent third heart sound ($S_3$). Lower extremities show trace pitting edema. Which of the following is the most appropriate next step in management?