Which medication should be discontinued in a patient with stage C heart failure due to its negative inotropic effects?

In patients with stage C heart failure, especially those who exhibit symptoms of reduced cardiac output, it is crucial to manage medication that may worsen heart function. Diltiazem is a calcium channel blocker that has negative inotropic effects, meaning it can decrease the strength of heart muscle contractions. This effect can exacerbate heart failure symptoms and lead to further compromise in cardiac performance.

In contrast, medications like metoprolol are often beneficial in heart failure management, as they can provide protective effects on the heart through beta-blockade, improving clinical outcomes over time. Furosemide plays an essential role in managing fluid overload in heart failure patients and does not have negative effects on cardiac contractility. Lisinopril, an ACE inhibitor, is crucial for heart failure treatment as it helps to reduce afterload and improve heart function.

Therefore, discontinuing diltiazem is appropriate in the context of managing stage C heart failure, while the other medications contribute positively to the treatment regimen.