In systolic dysfunction heart failure, which drug class is contraindicated?

In systolic dysfunction heart failure, which drug class is contraindicated?

• A. Calcium channel blockers
• B. ACE inhibitors
• C. Diuretics
• D. Digoxin

Answer: (A)

In systolic dysfunction heart failure, the heart’s pumping ability is already reduced, so anything that further lowers its contractility can worsen forward flow and symptoms. Calcium channel blockers, especially the non-dihydropyridine types like verapamil and diltiazem, have strong negative inotropic effects. By reducing calcium entry during contraction, they depress myocardial contractility and can decrease cardiac output, making them contraindicated in heart failure with reduced ejection fraction. Other standard HF medicines like ACE inhibitors help by reducing afterload and remodeling, diuretics relieve congestion, and digoxin can improve symptoms or allow rate control in atrial fibrillation. These are therapies that support function and outcomes in systolic HF, unlike calcium channel blockers.

In systolic dysfunction heart failure, the heart’s pumping ability is already reduced, so anything that further lowers its contractility can worsen forward flow and symptoms. Calcium channel blockers, especially the non-dihydropyridine types like verapamil and diltiazem, have strong negative inotropic effects. By reducing calcium entry during contraction, they depress myocardial contractility and can decrease cardiac output, making them contraindicated in heart failure with reduced ejection fraction.

Other standard HF medicines like ACE inhibitors help by reducing afterload and remodeling, diuretics relieve congestion, and digoxin can improve symptoms or allow rate control in atrial fibrillation. These are therapies that support function and outcomes in systolic HF, unlike calcium channel blockers.