Question

A 74-year-old man with HFrEF (LVEF 30%) remains symptomatic (NYHA II) on optimised ACE inhibitor and beta-blocker. eGFR 70; K+ 4.6 mmol/L. Next disease-modifying therapy to add?

Accepted Answer

Mineralocorticoid receptor antagonist (spironolactone)

Answer

Ivabradine

Answer

Loop diuretic (furosemide)

Answer

Hydralazine alone

Answer

Sacubitril/valsartan instead of ACE inhibitor immediately

Practice question

A 74-year-old man with HFrEF (LVEF 30%) remains symptomatic (NYHA II) on optimised ACE inhibitor and beta-blocker. eGFR 70; K+ 4.6 mmol/L. Next disease-modifying therapy to add?