A 71-year-old man with HFrEF remains breathless despite an ACE inhibitor, beta blocker and mineralocorticoid receptor antagonist. LVEF is 30%, eGFR

Question

A 71-year-old man with HFrEF remains breathless despite an ACE inhibitor, beta blocker and mineralocorticoid receptor antagonist. LVEF is 30%, eGFR 58 mL/min/1.73 m2 and HbA1c is 42 mmol/mol. Potassium is 4.6 mmol/L. What is the most appropriate management?

Accepted Answer

Add an SGLT2 inhibitor

Answer

Stop beta blockade due to persistent dyspnoea

Answer

Start long-term oral corticosteroids

Answer

Use digoxin as sole disease-modifying therapy

Answer

Add verapamil for rate support

Heart failure with reduced ejection fraction — RACP Written MCQ

A 71-year-old man with HFrEF remains breathless despite an ACE inhibitor, beta blocker and mineralocorticoid receptor antagonist. LVEF is 30%, eGFR 58 mL/min/1.73 m2 and HbA1c is 42 mmol/mol. Potassium is 4.6 mmol/L. What is the most appropriate management?