32496 investigations ultrasound doppler of the right leg negative for dvt I had the pleasure of meeting mister trevathan in same day emergency care today full stop he attended with concerns of a right leg dvt but this was excluded on ultrasonography full stop <\n\n> On examination he had pitting edema to the hips bilaterally stop heart sounds demonstrated a soft systolic murmur full stop chest auscultation rob it in headlights yes please I've had a right bunch of patients this week I didn't tell was clear and recent chest x-ray showed no evidence of pulmonary edema full stop <\n\n> Currently using furosemide 40 mg 3 times a day full stop <\n\n> I discussed that his scan does not demonstrate any dvt and his leg swelling is most likely secondary to pulmonary to peripheral edema secondary to ccf which he's already being treated for with furosemide full stop <\n\n> I've suggested switching his furosemide to bumetanide and taking 2 mg twice per day of this for improved absorption and likely gut edema full stop <\n\n> Echocardiogram was considered however symptom guided treatment seems to be most appropriate in this case full stop <\n\n> I'd suggest checking his easiness in 1 week's time to ensure no kidney injury on starting of bumetanide they'd be grateful if you could undertake this yours sincerely