A 62-year-old with HFrEF (LVEF 28%) tolerates lisinopril, carvedilol, and spironolactone. BP 120/70, K+ 4.5, creatinine 1.1. What next change best imp...

Question

A 62-year-old with HFrEF (LVEF 28%) tolerates lisinopril, carvedilol, and spironolactone. BP 120/70, K+ 4.5, creatinine 1.1. What next change best improves outcomes?

Accepted Answer

Switch ACE inhibitor to sacubitril/valsartan with a 36-hour washout

Answer

Add ivabradine regardless of heart rate

Answer

Stop beta-blocker and increase ACE inhibitor dose

Answer

Start hydralazine alone

Answer

Add chronic NSAID for pain control

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

A 62-year-old with HFrEF (LVEF 28%) tolerates lisinopril, carvedilol, and spironolactone. BP 120/70, K+ 4.5, creatinine 1.1. What next change best improves outcomes?