A 79-year-old lady was brought to the emergency department for worsening shortness of breath on exertion. Upon interviewing she admits sleeping on the couch for the past week because she gets shortness of breath if she laid down flat. She also has lower limb edema, her initial blood inves ga ons showed normal complete blood count, NT-pro BNP = 439 (normal =125) and the transthoracic echocardiogram showed le ventricular ejection fraction (LVEF) 55-69% and with no valvular abnormalities. She was given diuretics with furosemide, and she is feeling better. Which medication has been proven clinically to reduce the future hospitaliza on for this patient?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. SGLT2 inhibitor
She has HFpEF (orthopnea, edema, raised NT-proBNP, LVEF 55-69%). The cohort summary lists an SGLT2 inhibitor (dapagliflozin/empagliflozin) as first-line for all HFpEF patients, with loop diuretics for congestion; it reduces HF hospitalization. Metoprolol, perindopril and ARNI are HFrEF mortality drugs without that proven benefit in HFpEF (ARNI is only "may be considered").
ليش كل خيار صح أو غلط
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A
ليش صح
For HFpEF the first-line agents are an SGLT2 inhibitor for all patients (dapagliflozin or empagliflozin), plus a loop diuretic for congestion.
✓ HF summary.pdf · p. 4 -
B
ليش غلط
Beta-blockers are not in the HFpEF list: the first-line drug is an SGLT2 inhibitor.
✓ HF summary.pdf · p. 4 -
C
ليش غلط
An ACE inhibitor is not listed for HFpEF: the first-line drug is an SGLT2 inhibitor, with MRA or ARB only as options.
✓ HF summary.pdf · p. 4 -
D
ليش غلط
ARNI is only an optional agent in HFpEF ("may be considered"), not first-line.
✓ HF summary.pdf · p. 4
- المصدر
- HF summary.pdf · p. 4
- المحاضرة
- Heart Failure · Cardiology · Module B
- ظهر في
- Cardio bank