MediumCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 68-year-old man with a history of myocardial infarction presents with increasing orthopnoea and bilateral ankle oedema. On examination he has bibasal crackles, elevated jugular venous pressure and a displaced apex beat. Echocardiogram shows left ventricular ejection fraction 30%. He is on perindopril and frusemide. Blood pressure is 118/70 mmHg. What is the next best disease-modifying therapy to add?