A 60-year-old man comes to the office for follow up appointment. He feels shortenss of breath while walking his dog around the block. He states that he is experiencing a dyspnea while sleeping therefore he uses 3 pillows or sleep on the recliner. The patient had an acute myocardial infarction 2 years ago and has been nonadherent with his medications. Physical examination shows bibasilar lung crackles, jugular venous distension, and bilateral pitting edema in the lower extremities. Which of the following diuretics would most likely improve survival if added to this patient's current regimen?

Question

A 60-year-old man comes to the office for follow up appointment. He feels shortenss of breath while walking his dog around the block. He states that he is experiencing a dyspnea while sleeping therefore he uses 3 pillows or sleep on the recliner.   The patient had an acute myocardial infarction 2 years ago and has been nonadherent with his medications. Physical examination shows bibasilar lung crackles, jugular venous distension, and bilateral pitting edema in the lower extremities.  Which of the following diuretics would most likely improve survival if added to this patient's current regimen?

Quizplus · Accepted Answer

Eductional Objective: Mineralocorticoid receptor antagonists (eg, spironolactone, eplerenone) improve survival in patients with congestive heart failure and reduced left ventricular ejection fraction.  They should not be used in patients with hyperkalemia or renal failure.

A 60-Year-Old Man Comes to the Office for Follow Up