Question

A 64-year-old with HFrEF on sacubitril/valsartan, carvedilol, spironolactone, and empagliflozin remains NYHA III. BP 102/64, HR 72, K 4.6. Which therapy may reduce mortality further?

Accepted Answer

Add hydralazine plus isosorbide dinitrate (if Black or ACEi/ARB-intolerant)

Answer

Increase loop diuretic to maximum

Answer

Add digoxin first

Answer

Discontinue β-blocker to raise BP

Answer

Start non-evidence-based supplement

Practice question

A 64-year-old with HFrEF on sacubitril/valsartan, carvedilol, spironolactone, and empagliflozin remains NYHA III. BP 102/64, HR 72, K 4.6. Which therapy may reduce mortality further?