A 47-Year-Old Woman Is Evaluated for Exertional Dyspnea

A 47-year-old woman is evaluated for exertional dyspnea.  The patient is a smoker with type 2 diabetes mellitus, mild normocytic anemia, and stage 3 chronic renal disease.  Her family history is insignificant.  Blood pressure is 142/88 mm Hg and pulse is 76/min.  BMI is 32 kg/m².  Single photon emission CT images of the heart are obtained at rest and after 5 minutes of treadmill exercise by using separate intravenous injections of technetium-99-labeled perfusion agent, as seen below, with the bottom panel showing images of the heart at rest (REST) , and the top panel showing images of the heart after exercising (STRESS) . This patient would benefit most from which of the following medications?

A) Albuterol
B) Antiplatelet agent
C) Appetite suppressant
D) Erythropoietin
E) Metformin

Correct Answer:

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