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Heart failure with reduced ejection fraction — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Heart failure with reduced ejection fractionUSMLE Step 3

A 66-year-old man with ischemic cardiomyopathy has exertional dyspnea but no edema. Echocardiogram shows ejection fraction 32%. He takes lisinopril and furosemide. Blood pressure is 128/74 mm Hg, heart rate is 84/min, and creatinine and potassium are normal. Which of the following is the most appropriate next step in management?

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

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Correct answer: E — Add evidence-based beta-blocker therapy

Stable HFrEF should receive guideline-directed medical therapy including an evidence-based beta blocker unless contraindicated.

Reference: ACC/AHA/HFSA heart failure guideline: https://www.acc.org/