A 65-year-old man with a history of hypertension and coronary artery disease presents with orthopnea, paroxysmal nocturnal dyspnea, and bilateral lower limb edema. On exam: S3 gallop, bibasilar crackles, and elevated JVP.
BNP is elevated. Echocardiogram shows EF of 35%.
What is the most appropriate initial medication combination to reduce mortality in this patient?
A. Furosemide and Digoxin
B. ACE inhibitor and Beta-blocker
C. Nitrates and Hydralazine
D. Spironolactone and Loop diuretic
Drop your answer below!
Hint: Think guideline-directed medical therapy for HFrEF.