There are evidence of clinical benefit supporting the use of ACEI, while we do not know for sure whether that apply to ARB; therefore ARB is used only when patient cannot tolerate ACEI.
webjeee wrote:
sorry i put it as beta now
by the way, anyone can tell me what situation we pick ARB over ACEI.
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| Justice
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B ) Angiotensin-converting enzyme (ACE) inhibitor
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| eckimazuro
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This is a classical case of heart failure. The ACA/AHA guidelines are very specific about this condition, i.e. people who have signs of structural heart defects and heart failure are to be started on ACE-inhibitors. Only if these are not tolerated, are they started on ARB´s, and, if these are not tolerated, on hydralazine & nitrates.
Additionally, once low-dose ACE-I´s have been instituted, a beta-blocker (which the patient is already on) can and should be started. Diuretics are here probably not indicated, as there are no signs of hypervolemia, i.e. lungs are CTA.
Additionally, thiazide is a first-line drug in hypertension, but not very potent in HF.
Correct answer: ACE-I, i.e. B.
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| ram3
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This is heart failure so you give an ace inhibitor here have systolic dysfuction because the ef is less than forty percent but also an S4 is observed in diastolic dysfunction.
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| cirus
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The ans is ACE inhib as it ttt of hrt failure consists of ACE,BB,& Diuretics
The ace will decerease the mortality so its your ans
i was worried about thiazide but since there are no signs of edema I'd go for ACE first
Angiot recept blockers aren't used as first line, the are only used in case of contraindicated or intolerable ACE--->Hyperkalemia & Intractable cough
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| sailing boat
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| maninder_amc
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b) ACE Inhibitors
indications for use of ACE inhibitors post MI:
1. low ejection fraction (<40%)
2. LV dysfunction
if he doesnt tolerate ACE Inh, start ARB
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