HardCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 60-year-old man with ischaemic cardiomyopathy has an ejection fraction of 30% on echocardiography. He has NYHA class II symptoms despite optimal doses of an ACE inhibitor and a beta blocker. His blood pressure is 120/70 mmHg, potassium 4.5 mmol/L and eGFR 70 mL/min/1.73 m². He is euvolaemic with no peripheral oedema. According to Australian heart failure guidelines, which additional disease-modifying medicine should be added next?