Question

A 70-year-old woman with previous myocardial infarction presents with worsening breathlessness, orthopnoea and ankle swelling. Echocardiography shows heart failure with reduced ejection fraction (HFrEF). She is not yet on disease-modifying heart failure therapy. According to updated NICE guidance, what is the most appropriate initial pharmacological combination?

Accepted Answer

ACE inhibitor and a beta-blocker.

Answer

Loop diuretic alone.

Answer

ACE inhibitor and a long-acting nitrate.

Answer

Beta-blocker and a calcium-channel blocker.

Answer

Angiotensin receptor blocker alone.

Practice question