intern_doc
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72 y/o man comes b/c 6 months of mild to moderate SOB when climbing stairs. he has MI 2 yrs ago and had EF of 35% since then. his med Beta adrenergic blocking agent. the lung is clear to auscultation. cardiac exam show S4 gallop. there is no peripheral edema. lab is normal, ecg shows no acute changes. which of the following is the most appropriate pharmacotherapy ?
a. alpha adrenergic blocking agent
b. ACE
c. angiotensin2 recep blocking
d. nitrates
e. thiazide
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| phuluong2k
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C
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| merrk
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B.
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| bobby
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maybe you left out the correct ans. this patient needs digoxin.
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| merrk
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why? this pt has class 1 CHF. He should be started on ACE I first. Digoxin would be the next step.
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| chemamr
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i agree with merrk. ACEI would be the answer.
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| fongch
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Why not C? Aren't these 2 classes equivalent?
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| vradojc1
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ACE are less expensive. You'd give AT2 blockers in case ACE are needed but the patient cannot tolerate them (cough...)
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