A 43-Year-Old Man Is Being Evaluated for Occasional Retrosternal Chest

A 43-year-old man is being evaluated for occasional retrosternal chest pressure that develops with moderate exertion and sometimes occurs when resting.  He does not use alcohol, tobacco, or illicit drugs.  The patient has an extensive family history of coronary artery disease.  His temperature is 36.7 C (98 F) , blood pressure is 124/72 mm Hg, pulse is 81/min, and respirations are 14/min.  Physical examination shows no abnormalities.  Coronary angiography shows mild luminal irregularities but no significant obstructive lesions.  Acetylcholine infusion during the procedure results in dilation of epicardial coronary vessels.  A reaction involving which of the following amino acids is most likely responsible for the observed dilation?

A) Arginine
B) Aspartate
C) Glutamate
D) Tryptophan
E) Tyrosine

Correct Answer:

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