ModerateCardiovascularChronic heart failure with reduced ejection fractionuk-plab-1
A 69 year old woman with known heart failure with reduced ejection fraction (LVEF 30 percent) remains breathless on minimal exertion despite optimal doses of Ramipril and Bisoprolol. Her potassium is 4.6 mmol/L and eGFR 55 mL/min/1.73 m². According to NICE guidance, which additional drug class should be considered next to improve symptoms and prognosis?