08-15-2008, 11:57 AM
A 72-year-old man comes to the physician because of a 6-month history of mild to moderate shortness of breath when climbing stairs. He had a myocardial infarction 2 years ago and has had an ejection fraction of 35% since then. His only medication is a β-adrenergic blocking agent. The lungs are clear to auscultation. Cardiac examination shows an S4 gallop. There is no peripheral edema. Laboratory studies are within normal limits. An ECG shows no acute changes. Which of the following is the most appropriate pharmacotherapy?
A
) α-Adrenergic blocking agent
B
) Angiotensin-converting enzyme (ACE) inhibitor
C
) Angiotensin2-receptor blocking agent
D
) Nitrates
E
) Thiazide diuretic
A
) α-Adrenergic blocking agent
B
) Angiotensin-converting enzyme (ACE) inhibitor
C
) Angiotensin2-receptor blocking agent
D
) Nitrates
E
) Thiazide diuretic