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Ivabradine NOT Indicated at Low HR — EECC MCQ

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HardHeart FailureIvabradine NOT Indicated at Low HREECC

A patient with obstructive hypertrophic cardiomyopathy remains symptomatic despite beta-blockade. During exercise, the LVOT gradient rises from 25 to 85 mmHg and systolic anterior motion worsens. Which medication should generally be avoided?

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

Reveal the answer and explanation

Correct answer: E — A potent arterial or venous vasodilator

Preload or afterload reduction can intensify systolic anterior motion and dynamic obstruction. Potent nitrates and other vasodilators may therefore worsen symptoms, while negative inotropic strategies are selected according to haemodynamics and specialist guidance.

Reference: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines