24th April 2024

A 65-year-old Caucasian gentleman presents with persistent symptoms of dyspnoea and orthopnoea despite optimal medical management of his heart failure.

A 65-year-old Caucasian gentleman presents with persistent symptoms of dyspnoea and orthopnoea despite optimal medical management of his heart failure. He currently takes a furosemide 40mg BD, ramipril 7.5mg, bisoprolol 5mg BD, eplerenone 50 mg OD, and dapagliflozin 10 mg OD. His most recent echocardiogram demonstrates an ejection fraction of 30%. His observations today are: blood pressure 149/99 mmHg, heart rate 58 bpm, respiratory rate 14, saturation 98% on room air and temperature 37 degrees Celsius. You explain to him to stop his ramipril for 36 hours and provide a new prescription for a new medication. What is the mechanism of the medication prescribed? 

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