Heart Failure Management (NICE)

Question 1

First line heart failure management

Answer 1

Beta blocker and ACEI

Question 2

Second line heart failure management

Answer 2

Add in spironolactone

Question 3

Another drug to consider in heart failure but not in official treatment algorithm?

Answer 3

SGLT-2 inhibitors

Question 4

Heart failure 3rd line management

Answer 4

Initiated by specialist:

Ivabradine if HR >75 and LVEF <35%
Sacubitril-valsartan if LVEF <35%
Digoxin (improves symptoms but not mortality)
Hydralazine in combo with nitrate esp in afro-carribean patients
Cardiac resynchronisation therapy (if LBBB)