A 62-year-old man has ischemic cardiomyopathy with ejection fraction 28 percent, NYHA class II symptoms and blood pressure 118/72 mm Hg. He takes

Question

A 62-year-old man has ischemic cardiomyopathy with ejection fraction 28 percent, NYHA class II symptoms and blood pressure 118/72 mm Hg. He takes bisoprolol and furosemide. Potassium is 4.3 mmol/L and eGFR is 72 mL/min/1.73 m2. What is the most appropriate management?

Accepted Answer

Initiate foundational disease-modifying therapy with ARNI, MRA and SGLT2 inhibitor as tolerated

Answer

Use digoxin as first disease-modifying therapy

Answer

Increase loop diuretic until creatinine rises

Answer

Avoid beta-blockers because ejection fraction is low

Answer

Delay therapy until NYHA class IV symptoms develop

Heart failure with reduced EF — RCPSC IM MCQ

A 62-year-old man has ischemic cardiomyopathy with ejection fraction 28 percent, NYHA class II symptoms and blood pressure 118/72 mm Hg. He takes bisoprolol and furosemide. Potassium is 4.3 mmol/L and eGFR is 72 mL/min/1.73 m2. What is the most appropriate management?