Which medication is a priority in the management of congestive heart failure?

• A. Lasix
• B. Digoxin
• C. Nitroglycerin
• D. Beta-blocker

Answer: (A)

Relieving fluid overload is the priority in congestive heart failure because edema and shortness of breath stem from excess circulating volume and high preload. A loop diuretic such as furosemide works quickly to remove excess fluid by promoting natriuresis and diuresis, which lowers preload and reduces pulmonary and systemic congestion. This rapid symptom relief is why it’s the first-line choice for decongesting patients with heart failure. Digoxin can help with symptoms in some patients by boosting contractility but doesn’t address the fluid overload as effectively or quickly. Nitroglycerin lowers preload and can be useful in certain acute situations, but it isn’t the general initial priority for all heart failure cases. Beta-blockers improve long-term outcomes but require stabilization and careful initiation, so they’re not the immediate focus when volume overload is present.