A 6-year-old child with known dilated cardiomyopathy presents with tachypnea, hepatomegaly, and bilateral basal crepitations. Ejection fraction is 25%. Which of the following is the most appropriate first-line oral medication to improve long-term survival in this child?
- A Digoxin
- B Enalapril ✓
- C Frusemide
- D Amiodarone
Correct answer: B. Enalapril
Explanation
Afterload reduction with an ACE inhibitor such as enalapril is first-line therapy for heart failure with reduced ejection fraction in children and has proven mortality benefit. Diuretics address congestion but do not improve survival. Digoxin improves symptoms but not mortality. Amiodarone is for arrhythmias, not heart failure management.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.