skip to main content

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

Instant feedback + full explanation. One question, done properly.

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?

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

Reveal the answer and explanation

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

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

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