Cardiology · NEET PG Preparation Medicine
A 60-year-old male with chronic heart failure with reduced ejection fraction (HFrEF) is currently on maximally tolerated doses of an ACE inhibitor, a…
Practice question from Cardiology (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.
hard · MCQ · Q-281708
A 60-year-old male with chronic heart failure with reduced ejection fraction (HFrEF) is currently on maximally tolerated doses of an ACE inhibitor, a beta-blocker, and a mineralocorticoid receptor antagonist. Despite this therapy, he remains symptomatic with NYHA class III symptoms, a heart rate of 74 bpm, and a normal sinus rhythm. Which of the following agents should be added next to target his heart rate and reduce heart failure hospitalization?
- A.IvabradineCorrect answer
- B.Digoxin
- C.Amlodipine
- D.Hydralazine and isosorbide dinitrate
Solution
Ivabradine is an If channel blocker in the sinoatrial node that reduces heart rate without affecting myocardial contractility or blood pressure. Indications for its addition in HFrEF include symptomatic patients in normal sinus rhythm with an ejection fraction <= 35% and a resting heart rate >= 70 bpm despite maximally tolerated beta-blocker therapy.
More from Cardiology
- A 55-year-old male with a history of anterior ST-elevation myocardial infarction 2 years ago presents with progressively worsening dyspnea…
- A 68-year-old man presents with syncopal episodes. On examination, he has a delayed and weak carotid upstroke (pulsus parvus et tardus) and…
- A 45-year-old female presents with fatigue, dyspnea on exertion, and palpitations. Physical examination reveals an irregular pulse, a loud…
- A 28-year-old competitive athlete collapses during a soccer match and is brought to the emergency department, where he is declared dead. Po…
Practise more Medicine
Sign up free for adaptive practice on this chapter, with instant feedback and hints on every question.
Start practising freeFree to start · No credit card needed