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HFrEF-Adverse Effect Assessment — EECC MCQ

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EasyCardiologyHFrEF-Adverse Effect AssessmentEECC

A 62-year-old with HFrEF reports nocturnal cough after starting sacubitril/valsartan. K 4.5, creatinine stable. What is the most likely cause and action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Bradykinin effect is less with ARNI; continue and evaluate other causes

Explanation lettering: D = shown as A · C = shown as B · B = shown as C · A = shown as D

Cough is less frequent with ARNI than ACE inhibitors; evaluate alternative causes (e.g., fluid status, GERD). Immediate cessation for ACE-cough (B) misattributes; hyperkalemia/AKI (C,D) do not cause cough; anaphylaxis (E) is not consistent.

Reference: NICE NG106: Chronic heart failure in adults—diagnosis and management: https://www.nice.org.uk/guidance/ng106/chapter/recommendations