USMLE Step 3 Quiz
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CARDIOVASCULAR
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A 68-year-old man with Stage D ischemic HFrEF has had two hospitalizations in the past six months. He is on maximal medical therapy, including an ARNI, beta-blocker, MRA, SGLT2 inhibitor, and high-dose loop diuretics. He is frequently hypotensive (systolic BP 85-95 mmHg) and has an eGFR of 30 mL/min/1.73m². He asks what other options are available. Which of the following is the most appropriate next step?
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