ACEI

Question 1

Why are ACE inhibitors essential in HFrEF?

Answer 1

They counter chronic RAAS activation, improving symptoms and survival.

Question 2

What is the mechanism of ACEIs?

Answer 2

↓ Ang II, ↓ aldosterone, ↓ vasoconstriction, ↑ bradykinin → ↑ vasodilation.

Question 3

What are core clinical benefits of ACEIs?

Answer 3

↓ preload, ↓ afterload, ↓ congestion, ↑ CO, ↓ remodelling, ↑ survival.

Question 4

Who should receive ACEIs in HF?

Answer 4

All with HFrEF or HFmrEF, including asymptomatic LV dysfunction.
LV dysfunction of 40% or kess.

Question 5

What monitoring is required after starting an ACEI?

Answer 5

Renal function & electrolytes at baseline, 1–2 weeks, and after dose increases.

Question 6

List key adverse effects of ACEIs.

Answer 6

Cough, hypotension, hyperkalaemia, renal impairment, angioedema.

Question 7

When are ACEIs contraindicated?

Answer 7

Pregnancy, bilateral renal artery stenosis, previous angioedema, severe hypotension.