What is a key indication for considering hydralazine in heart failure management?

Hydralazine is particularly indicated for patients with heart failure who are intolerant to angiotensin-converting enzyme (ACE) inhibitors. This is important because ACE inhibitors are a cornerstone of heart failure treatment due to their ability to reduce afterload and improve cardiac output, as well as their role in mitigating neurohormonal activation. However, some patients may experience side effects from ACE inhibitors, such as cough or angioedema, which can lead to discontinuation of the medication.

In such cases, hydralazine offers an alternative option that can help manage heart failure symptoms without the adverse effects associated with ACE inhibitors. It acts as a vasodilator, helping to reduce systemic vascular resistance, which can ultimately improve cardiac output and reduce the workload on the heart. Thus, when a patient cannot tolerate ACE inhibitors, hydralazine becomes a valuable consideration in their treatment regimen.

The other choices do not align with the primary uses of hydralazine. For instance, while chronic obstructive pulmonary disease (COPD) is a separate condition, it does not directly indicate the use of hydralazine in heart failure management. Ventricular tachycardia is typically managed with antiarrhythmic medications rather than hydralazine, and first