A 62-year-old man was recently discharged after an MI. LVEF 38%, normal vitals, clear lungs. He takes aspirin, simvastatin and lisinopril. What should you add?
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الإجابة: A. Bisoprolol
After an MI every patient should be discharged on aspirin, a beta-blocker, a statin and an ACE inhibitor. This patient already takes aspirin, simvastatin and lisinopril, so the missing drug is a beta-blocker (bisoprolol), which is also indicated for his reduced LVEF. Ramipril would duplicate lisinopril; furosemide and digoxin are not needed with clear lungs and no congestion.
ليش كل خيار صح أو غلط
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A
ليش صح
After an MI every patient goes home on aspirin, a β-blocker, a statin and an ACE inhibitor. He lacks the β-blocker, so bisoprolol is the missing drug.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 19 -
B
ليش غلط
Digoxin is not a first-line HFrEF therapy. First-line drugs are ACEi/ARB, ARNI and β-blockers, with hydralazine plus a nitrate for those who cannot take ACEi/ARB/ARNI.
✓ Step-Up To Medicine 6th (HF).pdf · p. 8 -
C
ليش غلط
Diuretics treat volume overload and congestive symptoms. He has clear lungs and normal vitals, so there is no congestion to treat.
✓ Heart failure عبدالرحمن✅.pdf · p. 18 -
D
ليش غلط
He already takes an ACE inhibitor (lisinopril); the post-MI regimen needs one ACEi, so ramipril would duplicate it.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 19
- المصدر
- Step-Up To Medicine 6th (IHD & ACS).pdf · p. 19
Cardiology 🫀.pdf · p. 48 - المحاضرة
- Acute Coronary Syndrome · Cardiology · Module B
- ظهر في
- MED41 ♂ EOM B