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Diuretic resistance in HFrEF — EECC MCQ

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ModerateCardiologyDiuretic resistance in HFrEFEECC

A 70-year-old with HFrEF has persistent oedema despite high-dose loop diuretic. Which short-term strategy is recommended to overcome diuretic resistance?

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Correct answer: A — Add hydrochlorothiazide or metolazone for sequential nephron blockade

Sequential nephron blockade with a thiazide-type diuretic can overcome loop resistance short-term. Stopping diuretics, verapamil, or fluids are inappropriate; ACE inhibitors are not diuretics.

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