A 68-year-old man is seen for a follow-up. He has long-standing breathlessness and symptoms of heart failure due to left ventricular dysfunction. He is currently on enalapril 10 mg... A 68-year-old man is seen for a follow-up. He has long-standing breathlessness and symptoms of heart failure due to left ventricular dysfunction. He is currently on enalapril 10 mg OD, simvastatin 40 mg OD, furosemide 40 mg OD, and omeprazole 20 mg OD. Examination revealed that the chest is clear and heart sounds are normal. There is no peripheral edema. Blood pressure 125/83 mmHg, Heart rate 76/min. Which of the following is the most appropriate next step in the management at this stage? A. Add in digoxin B. Add in losartan C. Add in bisoprolol D. No additional medication indicated.
Understand the Problem
The question is asking for the most appropriate next step in the management of a 68-year-old man with heart failure due to left ventricular dysfunction who is currently on certain medications. The user needs to analyze the options provided to determine which medication or action should be taken next based on the clinical scenario.
Answer
Add in bisoprolol.
The final answer is Add in bisoprolol.
Answer for screen readers
The final answer is Add in bisoprolol.
More Information
In heart failure management, adding a beta-blocker like bisoprolol is recommended alongside ACE inhibitors like enalapril, especially in stable patients with no contraindications. Beta-blockers improve survival, reduce hospitalizations, and enhance symptoms in heart failure patients.
Tips
A common mistake is not considering beta-blockers early enough in managing heart failure with reduced ejection fraction. Ensure no contraindications and adjust the dose carefully.
Sources
- An Up-to-Date Article Regarding Drug Treatment in Heart Failure - pmc.ncbi.nlm.nih.gov
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