Cardiology MCQ 70

Q. All of the following have shown mortality benefit in heart failure except?

A. Eplerenone
B. Enalapril
C. Digoxin
D. Metoprolol

Answer: C. Digoxin

Explanation:

Drugs which have shown mortality benefit in patients with heart failure with reduced ejection fraction (HFrEF) are-

1. Beta blockers

2. ACE inhibitors

3. Angiotensin receptor blockers

4. Aldosterone antagonist

Digoxin did not show any survival advantage in these patients.

None of drugs till date have shown mortality benefit in patients with heart failure with preserved ejection fraction (HFpEF).

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ECG Spotter

What is the diagnosis? Click the button below to view answer: Show Answer

The patient contacts the doctor over phone with this report. Obviously anxious because of his high heart rate (199 beats per minute) as detected by ECG machine. Should he be worried about this and come to emergency department as soon as possible? Correct answer- ECG machine has calculated his heart rate incorrectly. Heart rate is around 100 beats per minute. Other findings in this ECG include ST segment elevation in anterior chest leads along with presence of Q waves, denoting old MI changes with possibly development of LV aneurysm. In such cases, ST segment elevation can persist for long periods. Now, should he come to emergency department? Not because of detection of high heart rate. But, if he is having symptoms such as shortness of breath or chest pain, he should visit emergency department. Otherwise, if he is asymptomatic, he can schedule a regular visit with his cardiologist.

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