6th May 2025

A 62-year-old man attends the cardiology clinic with persistent shortness of breath on exertion (SOBOE) and bilateral peripheral oedema.

A 62-year-old man attends the cardiology clinic with persistent shortness of breath on exertion (SOBOE) and bilateral peripheral oedema. The SOBOE is significantly limiting his activities of daily living and he is unable to walk from the living room to the toilet without pausing for breath. An echocardiogram reveals an LVEF of 41%. His regular medications include ramipril, carvedilol, atorvastatin and metformin. He has no drug allergies.

Which of the following would be the next most appropriate medication to prescribe for the management of his heart failure?

Select the SINGLE most appropriate option from the list below. Select ONE option only.