Paper I
2019 February (2010 Scheme) · 40 marks · 120 min

Question

Angiotensin converting enzyme inhibitor in congestive cardiac failure

Q91 marksShort Answers

Answer

ACE inhibitors reduce both afterload (by blocking angiotensin II-mediated vasoconstriction) and preload (by reducing aldosterone-mediated sodium/water retention), reducing the workload on the failing heart. They also prevent angiotensin II-mediated adverse cardiac remodelling and fibrosis, which slows disease progression. This combination of haemodynamic benefit and prevention of remodelling is why ACE inhibitors improve both symptoms and long-term survival in congestive cardiac failure, forming a cornerstone of CCF therapy.

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