A 68-year-old man with ischaemic cardiomyopathy (left ventricular ejection fraction 30%) and NYHA class II symptoms is reviewed in clinic. He is on fr...

Question

A 68-year-old man with ischaemic cardiomyopathy (left ventricular ejection fraction 30%) and NYHA class II symptoms is reviewed in clinic. He is on frusemide as required but no other heart failure medications. According to contemporary Australian guideline-based practice, what is the most appropriate next step?

Accepted Answer

Start an ACE inhibitor and a beta-blocker, titrating both to target doses as tolerated

Answer

Add a beta-blocker alone

Answer

Add an ACE inhibitor alone

Answer

Start spironolactone as sole disease-modifying therapy

Answer

Make no changes as his symptoms are only mild

au-racp MCQ (SBA): Heart failure with reduced ejection fraction