Emergency Department

You are a junior doctor in the Emergency Department. Your supervisor is Dr. Taylor. It is a hot summer night and things have been generally quiet. You take this opportunity to revise the Top 100 Drugs, when an ambulance pulls in. 

Faith Reed, a 62-year old Caucasian woman, is brought in, accompanied by her daughter, Jane, who is six months pregnant. Mrs. Reed is clearly distressed and she reports that she woke up suddenly with severe shortness of breath and palpitations. On examination she appears cold, clammy and sweaty. Bi-basal crepitations are heard in her lungs. Her blood pressure is 198/95 mmHg and heart rate is 125 bpm. Oxygen saturation is 80%. 

You ask about her medical history and Mrs. Reed reports that she was diagnosed with heart failure two years ago and hypertension ten years ago. 

You decide that pharmacological treatment is warranted for Mrs. Reed's acute heart failure. 

What is the most appropriate drug for Mrs. Reed?