A 72-year-old woman with HFrEF (EF 28%) on ARNI, beta-blocker, and SGLT2 inhibitor has K⁺ 5.3 mEq/L and eGFR 55. She was started on spironolactone 25 ...

Question

A 72-year-old woman with HFrEF (EF 28%) on ARNI, beta-blocker, and SGLT2 inhibitor has K⁺ 5.3 mEq/L and eGFR 55. She was started on spironolactone 25 mg daily 2 weeks ago. What is the best action?

Accepted Answer

Continue spironolactone and monitor potassium closely; consider dose adjustment

Answer

Stop all HF medications

Answer

Increase spironolactone to 50 mg daily

Answer

Switch beta-blocker to atenolol

Answer

Start potassium supplements

us-abim MCQ (SBA): Heart Failure Management

A 72-year-old woman with HFrEF (EF 28%) on ARNI, beta-blocker, and SGLT2 inhibitor has K⁺ 5.3 mEq/L and eGFR 55. She was started on spironolactone 25 mg daily 2 weeks ago. What is the best action?