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    Subjects/Anatomy/Diaphragm — Openings and Innervation
    Diaphragm — Openings and Innervation
    medium
    bone Anatomy

    A 52-year-old man from Delhi presents with progressive dyspnea and orthopnea for 3 months. Clinical examination reveals reduced breath sounds at both lung bases and dullness to percussion. Chest X-ray shows bilateral pleural effusions. On further questioning, he reports a 6-month history of progressive abdominal distension and ankle edema. Liver function tests show elevated transaminases and low albumin. Ultrasound abdomen reveals cirrhosis with ascites. The patient is suspected to have hepatic hydrothorax secondary to cirrhosis. Which of the following is the most appropriate immediate next step in management?

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