A 66-year-old with HFrEF (EF 30%) is on sacubitril/valsartan, metoprolol succinate, and spironolactone. He remains symptomatic (NYHA II). What additio...

Question

A 66-year-old with HFrEF (EF 30%) is on sacubitril/valsartan, metoprolol succinate, and spironolactone. He remains symptomatic (NYHA II). What additional foundational therapy improves morbidity and mortality?

Accepted Answer

Add an SGLT2 inhibitor

Answer

Add long-acting nitrate for all patients

Answer

Switch to diltiazem for rate control

Answer

Add hydralazine alone

Answer

Target only diuretics for symptom relief

us-abfm MCQ (SBA): HFrEF Guideline-Directed Therapy

A 66-year-old with HFrEF (EF 30%) is on sacubitril/valsartan, metoprolol succinate, and spironolactone. He remains symptomatic (NYHA II). What additional foundational therapy improves morbidity and mortality?