Question

A 58-year-old with HFrEF (LVEF 30%) NYHA II on lisinopril and metoprolol succinate, euvolemic, creatinine 1.0, K+ 4.6. Guideline-directed next step to reduce mortality?

Accepted Answer

Switch ACE inhibitor to sacubitril/valsartan and add an SGLT2 inhibitor and an MRA as tolerated

Answer

Add digoxin

Answer

Add ivabradine

Answer

Stop beta-blocker and increase ACE inhibitor

Answer

Add amlodipine for afterload reduction

Practice question

A 58-year-old with HFrEF (LVEF 30%) NYHA II on lisinopril and metoprolol succinate, euvolemic, creatinine 1.0, K+ 4.6. Guideline-directed next step to reduce mortality?