50-year-old man comes to the emergency department due to acute onset respiratory difficulty

50-year-old man comes to the emergency department due to acute onset respiratory difficulty. He also has

periorbital, circumoral and facial edema. He denies any itching or skin rash. Two weeks ago, he experienced chest

pain, profuse sweating and anxiety, and was subsequently admitted to the cardiac intensive care unit. At that time,

his ECG showed ST segment elevation and Q waves in the inferior leads. He was taken to the catheterization lab

and had an angioplasty with stent done for 100% occlusion of the right coronary artery. He was discharged with

the following medications: aspirin, clopidogrel, metoprolol, enalapril, simvastatin and isosorbide mononitrate. In the

ED, his pulse is 102/min, blood pressure is 110/70 mmHg, respirations are 24/min and temperature is 36.8°C

(98.4°F). Which of the following is most likely responsible for his present symptoms?

  • Q A. Metoprolol
  • 0 B. lsosorbide
  • 0 C. Clopidogrel
  • 0 D. Aspirin
  • 0 E. Enalapril
  • 0 F. Simvastatin

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