Guidelines: 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure – Question #25 With Dr. Mark Drazner

By CardioNerds - Last Updated: December 1, 2023

The question presented in this CardioNerds podcast refers to Sections 6.1 and 7.3 of the 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure.

The question was asked by Hirsh Elhence, a medical student at the Keck School of Medicine of the University of Southern California and a former CardioNerds intern. Dr. Alaa Diab, a CardioNerds Academy Fellow and resident at the Greater Baltimore Medical Center, and expert faculty Dr. Mark Drazner provide an answer. Dr. Drazner is an advanced heart failure and transplant cardiologist, professor of medicine, and the clinical chief of cardiology at UT Southwestern. He was previously president of the Heart Failure Society of America.

A 50-year-old man with a history of type 2 diabetes mellitus, persistent atrial fibrillation, coronary artery disease with prior remote percutaneous coronary intervention, and ischemic cardiomyopathy with HFrEF (LVEF 38%) presents to your outpatient clinic. He denies dyspnea on exertion, orthopnea, bendopnea, paroxysmal nocturnal dyspnea, or peripheral edema. His irregular heart rate is 112 beats per minute. His blood pressure is 112/67 mmHg. Routine laboratory studies reveal a hemoglobin A1c of 7.7%. Which of the following medications should not be used to control this patient’s comorbidities?
A Metoprolol succinate
B Verapamil
C Dapagliflozin
D Pioglitazone
E Both B and D


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