A 66-year-old man with HFrEF and diabetes is on ACE inhibitor, beta-blocker, MRA, and SGLT2 inhibitor. He remains symptomatic NYHA II-III. Next class ...

Question

A 66-year-old man with HFrEF and diabetes is on ACE inhibitor, beta-blocker, MRA, and SGLT2 inhibitor. He remains symptomatic NYHA II-III. Next class to consider?

Accepted Answer

Hydralazine-isosorbide dinitrate (especially if Black or ACEi/ARB intolerance)

Answer

Non-DHP calcium channel blocker

Answer

Alpha-blocker for BP

Answer

Discontinue SGLT2 inhibitor

Answer

Increase loop diuretic dose only

us-abim MCQ (SBA): Advanced HFrEF Add-On Therapy

A 66-year-old man with HFrEF and diabetes is on ACE inhibitor, beta-blocker, MRA, and SGLT2 inhibitor. He remains symptomatic NYHA II-III. Next class to consider?