National Physical Therapy Examination (NPTE) Practice Exam

A patient with an ejection fraction of 40% is likely experiencing heart failure or poor cardiac function, which is often associated with conditions such as left ventricular dysfunction. In such cases, angiotensin-converting enzyme (ACE) inhibitors are a primary choice for management. ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II, resulting in vasodilation and reduced blood pressure. This helps decrease the workload on the heart and improves diastolic filling, ultimately enhancing the overall cardiac output.

Additionally, ACE inhibitors have been shown to reduce mortality in patients with heart failure and improve symptoms, making them especially beneficial for patients with a notably low ejection fraction. They are considered a cornerstone in the treatment of heart failure with reduced ejection fraction.

Other classes of medications mentioned serve different purposes. Nitrate agents primarily dilate blood vessels and are often used for angina or acute heart failure situations, but they do not have the same protective effects on mortality as ACE inhibitors. Anticholinergic agents affect the autonomic nervous system and are generally not used in heart failure management. Thrombolytic agents are used to dissolve blood clots in conditions like acute myocardial infarction rather than for chronic management of heart function. Thus,