Question

A 70-year-old man with known heart failure with reduced ejection fraction (HFrEF) is on Ramipril and Bisoprolol at target doses but remains NYHA class II–III. His renal function and potassium are normal. What is the most appropriate additional disease-modifying drug?

Accepted Answer

Add Spironolactone

Answer

Add a thiazide diuretic only

Answer

Add Digoxin as first choice

Answer

Stop ACE inhibitor and start high-dose loop diuretic alone

Answer

Add a calcium-channel blocker such as Amlodipine as first-line

Practice question

A 70-year-old man with known heart failure with reduced ejection fraction (HFrEF) is on Ramipril and Bisoprolol at target doses but remains NYHA class II–III. His renal function and potassium are normal. What is the most appropriate additional disease-modifying drug?