Review Question - QID 109434

A 67-year-old man presents to the emergency department for shortness of breath. He was mowing his lawn when his symptoms started and they have not improved after rest. The patient has a medical history of obesity, diabetes, hypertension, cardiac surgery, and peripheral arterial disease. His current medications include aspirin, hydrochlorothiazide, lisinopril, insulin, metformin, and ibuprofen. His temperature is 99.5°F (37.5°C), blood pressure is 80/50 mmHg, pulse is 117/min, respirations are 18/min, and oxygen saturation is 95% on room air. An ECG and a chest radiograph are both within normal limits. On physical exam, the patient has notable jugular venous distention. A pulmonary exam reveals mild bilateral crackles. A cardiac exam reveals diminished heart sounds with normal S1 and S2 spacing. A neurological exam is within normal limits. After fluid resuscitation, the patient's repeat vitals include a blood pressure of 84/52 mmHg and a pulse of 142/min. Which of the following is the most appropriate next step in management?