EasyCardiovascularHeart failure with reduced ejection fractionuk-plab-1
A 64-year-old man with a history of ischaemic heart disease presents with ankle swelling, exertional dyspnoea and orthopnoea. Echocardiography shows a left ventricular ejection fraction of 32%. His blood pressure is 130/78 mmHg and kidney function is normal. What is the most appropriate first-line disease-modifying therapy to start alongside a loop diuretic?