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HFrEF add-on therapy — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsHFrEF add-on therapyGPhC CRA

A 70-year-old man with HFrEF remains breathless despite ramipril and bisoprolol; eGFR is 62 and potassium is 4.6 mmol/L. What is the most appropriate alternative?

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

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Correct answer: DAdd spironolactone with renal and electrolyte monitoring

A mineralocorticoid receptor antagonist can improve outcomes in symptomatic HFrEF when renal function and potassium permit use. This makes add spironolactone with renal and electrolyte monitoring the single best answer in this scenario. The other options would either miss the key safety issue, delay appropriate review, or fail to meet the relevant clinical or professional requirement.

Reference: NICE CKS; BNF