HF – captopril — RACP Paediatrics MCQ

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EasyCardiologyHF – captoprilRACP Paediatrics

The same infant with VSD and heart failure is started on frusemide. What ACE inhibitor should be added to reduce afterload and improve cardiac output?

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Correct answer: B — Captopril

Captopril is the most commonly used ACE inhibitor in infants with heart failure. It reduces afterload (systemic vascular resistance), which is particularly beneficial in left-to-right shunts (VSD) where it reduces the shunt fraction. Dosing starts low and is titrated up. BP and renal function monitoring is required.

Reference: RCH Melbourne – 2023 – Heart Failure CPG; RACP Paediatric Curriculum – Cardiology