A 72-year-old male with a history of ischemic cardiomyopathy presents to the emergency department with worsening dyspnea, orthopnea, and bilateral lower extremity edema. Physical examination reveals jugular venous distension, an S3 gallop, and crackles at the lung bases. His blood pressure is 150/90 mmHg. What is the most appropriate initial pharmacological intervention?
✓ Correct Answer: Option B
Worsening heart failure symptoms, JVD, S3, and crackles indicate acute decompensated heart failure with volume overload. Loop diuretics like furosemide are the initial treatment to reduce preload and alleviate congestion.