RT Book, Section A1 Katzung, Bertram G. A2 Katzung, Bertram G. A2 Vanderah, Todd W. SR Print(0) ID 1176970355 T1 Drugs Used in Heart Failure T2 Basic & Clinical Pharmacology, 15e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260452310 LK accessmedicine.mhmedical.com/content.aspx?aid=1176970355 RD 2024/03/28 AB CASE STUDYA 55-year-old man noticed shortness of breath with exertion while on a camping vacation in a national park*. He has a 15-year history of poorly controlled hypertension. The shortness of breath was accompanied by onset of swelling of the feet and ankles and increasing fatigue. On physical examination in the clinic, he is found to be mildly short of breath lying down but feels better sitting upright. Pulse is 100 bpm and regular, and blood pressure is 165/100 mm Hg. Crackles are noted at both lung bases, and his jugular venous pressure is elevated. The liver is enlarged, and there is 3+ edema of the ankles and feet. An echocardiogram shows an enlarged, poorly contracting heart with a left ventricular ejection fraction of about 30% (normal: 60%). The presumptive diagnosis is stage C, class III heart failure with reduced ejection fraction. What treatment is indicated?