HF – carvedilol — RACP Paediatrics MCQ

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HardCardiologyHF – carvedilolRACP Paediatrics

A 10-year-old with dilated cardiomyopathy on maximal medical therapy (frusemide, captopril, spironolactone) remains symptomatic with EF 25%. Heart rate is 110 bpm. What additional medication has evidence for improving outcomes in paediatric heart failure?

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Correct answer: C — Carvedilol

Carvedilol (a beta-blocker with alpha-blocking properties) is used as adjunctive therapy in paediatric chronic heart failure, particularly dilated cardiomyopathy. It must be initiated at low doses and titrated slowly (risk of initial worsening). Evidence from adult trials and paediatric observational data supports its role in improving ventricular function and reducing mortality.

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