Question

A 55-year-old man with chronic heart failure and left ventricular ejection fraction 30% is on optimal doses of Ramipril and Bisoprolol but remains symptomatic (NYHA class II–III). What is the next disease-modifying drug that should be considered?

Accepted Answer

Mineralocorticoid receptor antagonist (for example, Spironolactone)

Answer

Digoxin

Answer

Loop diuretic (Frusemide)

Answer

Ivabradine

Answer

Long-acting nitrate

Practice question

A 55-year-old man with chronic heart failure and left ventricular ejection fraction 30% is on optimal doses of Ramipril and Bisoprolol but remains symptomatic (NYHA class II–III). What is the next disease-modifying drug that should be considered?