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Heart Failure with Reduced Ejection Fraction (HFrEF) — EECC MCQ

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ModerateMRAHeart Failure with Reduced Ejection Fraction (HFrEF)EECC

A 68-year-old with HFrEF (LVEF 30%) NYHA II is not yet on guideline-directed therapy. Which initial regimen best reflects foundational quadruple therapy?

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Correct answer: B — ARNI (sacubitril/valsartan) + evidence-based beta-blocker + mineralocorticoid receptor antagonist + SGLT2 inhibitor

Foundational therapy for HFrEF includes ARNI (or ACEi/ARB if ARNI not tolerated), evidence-based beta-blocker, MRA, and an SGLT2 inhibitor. Diuretics treat congestion but are not part of the core mortality-reducing quartet (A, D). Digoxin and verapamil are not foundational mortality-reducing agents (C, E).

Reference: NICE guideline [NG235] Heart failure: diagnosis and management