Heart failure - chronic treatment

Question 1

Step 1 (2)

Answer 1

ACEi

Beta blocker

Question 2

Step 2

Answer 2

Aldosterone antagonist (spironolactone, eplerenone)

Question 3

Step 3 - sinus rhythm >75/min + LVEF <35%

Answer 3

Ivabradine

Question 4

Step 3 - LVEF <35% + symptomatic on ACEi or ARBs

Answer 4

Sacubitril-valsartan

Question 5

Step 3 - coexistent AF

Answer 5

Digoxin

Question 6

Step 3 - Afro Caribbean patients who do not respond to steps 1 and 2

Answer 6

Hydralazine + nitrate

Question 7

Step 3 - widened QRS (LBBB)

Answer 7

Cardiac resynchronisation therapy