Answer
• Attempt to initiate and optimize ACE inhibitor (increases survival) and beta blocker
for LV systolic dysfunction when patients is stable
• Blood pressure, renal function, electrolytes should be monitored
when titrating ACEi
– ~30% rise in creatinine may be expected with ACEi
• Start beta blocker only when patient is stable and compensated
– Negative inotrope effects in short‐term
– Avoid abrupt withdrawl