MediumCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 68-year-old man with ischaemic cardiomyopathy (left ventricular ejection fraction 30%) presents for routine review. He has NYHA class II symptoms despite being on optimal doses of perindopril and frusemide. Blood pressure is 118/70 mmHg, heart rate 74 beats/min, and renal function is stable. According to Australian heart failure guidelines, which additional pharmacological therapy should be introduced next to improve prognosis?