Authors: Michael A. Evans, MD and Eric Vu, MD – Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern Feinberg School of Medicine


A 23-year-old woman with Hallerman-Streif syndrome, mixed mitral valve disease, and restrictive cardiomyopathy presents to the cardiac intensive care unit due to acute on chronic heart failure. Her home medication regimen consists of metoprolol, digoxin, aldactone, and enalapril. During her inpatient stay, she is transitioned from enalapril to sacubitril/valsartan. What is the mechanism of action of sacubitril?