What is the primary action of digoxin in patients with congestive heart failure?

Digoxin primarily acts by improving the strength and efficiency of heart contractions in patients with congestive heart failure. It is a cardiac glycoside that has a positive inotropic effect, which means it increases the force of the heart's contractions. This is particularly beneficial for patients with heart failure, where the heart is unable to pump effectively, leading to symptoms like fatigue, shortness of breath, and fluid retention.

By enhancing myocardial contractility, digoxin helps increase cardiac output, allowing the heart to pump more effectively and meet the body's demands. This improved pumping action can also help alleviate symptoms of heart failure, improving the overall quality of life for affected individuals.

Other options, while they may seem relevant to heart failure management, do not accurately describe the primary action of digoxin. Decreasing heart rate can occur with digoxin but is not its primary action. Lowering blood pressure and reducing fluid retention are not direct effects of digoxin; these aspects are often managed with other medications specifically designed for those outcomes in heart failure treatment.