A 62-year-old man with a history of myocardial infarction presents with worsening dyspnea and orthopnea. His chest X-ray shows pulmonary edema and cardiomegaly. His ejection fraction is 25%. Which medication is contraindicated in this patient?
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✓ Correct answer: D. Non-dihydropyridine calcium channel blockerNon-dihydropyridine calcium channel blockers (verapamil, diltiazem) are contraindicated in heart failure with reduced ejection fraction as they have negative inotropic effects that can worsen heart failure. Beta-blockers, ACE inhibitors, and aldosterone antagonists are all part of guideline-directed medical therapy for HFrEF.
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