A 58-year-old with HFrEF (EF 30%) NYHA II on lisinopril is clinically euvolemic. BP 118/70 mm Hg, K⁺ 4.6 mEq/L, eGFR 65. Best next step to optimize gu...

Question

A 58-year-old with HFrEF (EF 30%) NYHA II on lisinopril is clinically euvolemic. BP 118/70 mm Hg, K⁺ 4.6 mEq/L, eGFR 65. Best next step to optimize guideline-directed medical therapy (GDMT)?

Accepted Answer

Switch ACE inhibitor to sacubitril/valsartan and add evidence-based beta-blocker

Answer

Add digoxin immediately

Answer

Withhold RAAS therapy due to potassium 4.6

Answer

Start hydralazine/isosorbide mononitrate as first-line

Answer

Start verapamil for rate control

us-abim MCQ (SBA): Heart Failure (HFrEF)

A 58-year-old with HFrEF (EF 30%) NYHA II on lisinopril is clinically euvolemic. BP 118/70 mm Hg, K⁺ 4.6 mEq/L, eGFR 65. Best next step to optimize guideline-directed medical therapy (GDMT)?