EUNACOM Sección Teórica Practice Questions - Chile EUNACOM Sección Teórica - Examen Único Nacional De Conocimientos De Medicina Exam

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A 64-year-old female with ischemic cardiomyopathy has chronic heart failure with reduced ejection fraction (LVEF 28%). She is in NYHA functional class II, taking enalapril 10 mg twice daily and bisoprolol 5 mg daily. Her blood pressure is 122/76 mmHg, heart rate is 64 bpm, serum potassium is 4.2 mEq/L, and estimated GFR is 68 mL/min/1.73 m2. According to international and Chilean clinical practice guidelines, which additional medication class should be added next to reduce cardiovascular mortality?

A mineralocorticoid receptor antagonist (spironolactone) and an SGLT2 inhibitor (dapagliflozin or empagliflozin) A non-dihydropyridine calcium channel blocker (diltiazem) to optimize rate control Oral digoxin to increase myocardial contractility and improve ejection fraction Oral hydralazine plus isosorbide dinitrate to replace ACE inhibitor therapy

Correct Answer:

A mineralocorticoid receptor antagonist (spironolactone) and an SGLT2 inhibitor (dapagliflozin or empagliflozin)

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