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HFrEF optimization — RCPSC IM MCQ

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ModerateCardiologyHFrEF optimizationRCPSC IM

A 64-year-old man with known heart failure with reduced ejection fraction is stable after admission for pulmonary oedema. LVEF is 28 percent. He is taking low-dose bisoprolol and furosemide only. eGFR is 54 mL/min/1.73 m2, potassium is 4.3 mmol/L, and blood pressure is 118/70 mm Hg. What is the most appropriate next step?

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

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Correct answer: E — Initiate guideline-directed foundational HFrEF therapy before discharge

A stable patient with HFrEF should leave hospital on optimized guideline-directed therapy when tolerated, including ARNI or ACE inhibitor/ARB, beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor.

Reference: CCS/CHFS heart failure guideline update