رجل عمره ٦٦ سنة عنده فشل قلب مزمن مع ضعف في ضخ البطين (EF ٣٠٪)، بدأ كارفيديلول بجرعة صغيرة تُرفع تدريجياً. نبضه نزل من ٩٢ إلى ٦٨، ويقول إنه يتعب أكثر قليلاً في أول أسبوعين. يسأل لماذا يأخذه مع أنه يبطئ قلبه. أي إجابة صحيحة؟

A 66-year-old man with chronic heart failure (EF 30%) started low-dose carvedilol with gradual up-titration. His HR fell from 92 to 68 and he feels slightly more tired in the first two weeks. He asks why he takes it when it slows his heart. Which answer is correct?

1. It only widens the coronary arteries to stop angina attacks
2. It strengthens contraction quickly, easing breathlessness from the first dose
3. It protects the heart muscle long-term and lowers admissions and deaths
4. It removes excess fluid from the body like a diuretic

Answer: C) It protects the heart muscle long-term and lowers admissions and deaths. Evidence-based beta-blockers in heart failure, such as carvedilol, improve survival and reduce admissions over time. They are started low and titrated slowly, and fatigue may increase at first.