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MCQ 15: Congestive heart failure (18)

Q. Which of the following drug may be stopped in asymptomatic patients with low left ventricular ejection fraction?
A. Beta blocker
B. ACE inhibitor
C. Diuretic
D. All of them should be stopped unless patient is symptomatic
Answer: C. Diuretic

Explanation:
Beta blockers and ACE inhibitors are used in CHF because they have suvival benefit. Both of these are class I recommendation in patients with heart failure with reduced ejection fraction (HFrEF). Whereas, Diuretics are used only for symptomatic benefit. So, if the patient is asymptomatic but having low ejection fraction, beta blockers and ACE inhibitors should be continued and diuretics are given according to symtoms of the patient. 
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