Question

A 66-year-old with heart failure with reduced ejection fraction (HFrEF) (EF 30%) is on ACE inhibitor and β-blocker at target doses. He remains symptomatic NYHA II-III. Next disease-modifying therapy to add?

Accepted Answer

Mineralocorticoid receptor antagonist (e.g., spironolactone)

Answer

Digoxin

Answer

Loop diuretic

Answer

Ivabradine first

Answer

Sacubitril/valsartan instead of ACEi

Practice question

A 66-year-old with heart failure with reduced ejection fraction (HFrEF) (EF 30%) is on ACE inhibitor and β-blocker at target doses. He remains symptomatic NYHA II-III. Next disease-modifying therapy to add?