Diuretic Strategy in HF — EECC MCQ

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ModerateCardiologyDiuretic Strategy in HFEECC

A 62-year-old with HFrEF and persistent volume overload on furosemide asks about adding metolazone. What is the rationale?

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Correct answer: B — Sequential nephron blockade can augment diuresis

Thiazide-type diuretics (e.g., metolazone) can be added transiently with loop diuretics for refractory congestion (sequential nephron blockade). They do not replace loops; mortality impact is not direct; combination requires monitoring.

Reference: AHA/ACC/HFSA Guideline (2022): Heart Failure