24th July 2020

A 75-year-old patient with a 10-year history of heart failure presents to the clinic with persistent symptoms (peripheral oedema) and decreased exercise tolerance during ordinary activities

A 75-year-old patient with a 10-year history of heart failure presents to the clinic with persistent symptoms (peripheral oedema) and decreased exercise tolerance during ordinary activities. Upon the examination, his left ventricular ejection fraction (LVEF) is 35%. He has been taking lisinopril and carvedilol as prescribed, in the maximum tolerated dose.

What would be the most appropriate next step in his management?

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