A 64-year-old with HFrEF (EF 30%) on maximally tolerated ACE inhibitor and evidence-based beta-blocker, NYHA II, eGFR 45, K+ 4.7 mEq/L. Which addition...

Question

A 64-year-old with HFrEF (EF 30%) on maximally tolerated ACE inhibitor and evidence-based beta-blocker, NYHA II, eGFR 45, K+ 4.7 mEq/L. Which additional disease-modifying therapy should be initiated regardless of diabetes status?

Accepted Answer

Start dapagliflozin 10 mg daily

Answer

Increase ACE inhibitor to maximum dose before adding anything

Answer

Add hydralazine/isosorbide dinitrate now

Answer

Start ivabradine

Answer

Switch beta-blocker to carvedilol only

us-abim MCQ (SBA): Heart Failure (HFrEF)

A 64-year-old with HFrEF (EF 30%) on maximally tolerated ACE inhibitor and evidence-based beta-blocker, NYHA II, eGFR 45, K+ 4.7 mEq/L. Which additional disease-modifying therapy should be initiated regardless of diabetes status?