A 58-year-old with heart failure with reduced ejection fraction (EF 32%) is on ACE inhibitor and beta-blocker. He remains symptomatic (NYHA II). Next ...

Question

A 58-year-old with heart failure with reduced ejection fraction (EF 32%) is on ACE inhibitor and beta-blocker. He remains symptomatic (NYHA II). Next disease-modifying agent?

Accepted Answer

Add mineralocorticoid receptor antagonist

Answer

Add diltiazem

Answer

Add ivabradine regardless of sinus rate

Answer

Switch ACEI to hydralazine-isosorbide first

Answer

Add loop diuretic only

ukmla MCQ (SBA): Heart Failure (HFrEF)

A 58-year-old with heart failure with reduced ejection fraction (EF 32%) is on ACE inhibitor and beta-blocker. He remains symptomatic (NYHA II). Next disease-modifying agent?