MediumCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 70-year-old man with a history of ischaemic cardiomyopathy (left ventricular ejection fraction 30%) is clinically euvolaemic. Current medications are perindopril 4 mg daily and frusemide 40 mg daily. His heart rate is 78 beats/min in sinus rhythm. According to evidence-based heart failure management, what is the next most appropriate long-term pharmacological step?