ACE and acute kidney injury: Recommended pharmacotherapy is as per general population guidelines, with caveats for cyanotic patients (angiotensin-converting enzyme [ACE] inhibitors and diuretics should be limited to necessary instances and monitored closely), Eisenmenger physiology (extreme caution with vasodilating agents that could accentuate right to left shunting), and residual aortic coarctation (ACE inhibitors may precipitate acute renal failure and should be used with vigilance) (22).