July 26th, 2020
A 58-year-old man comes to the physician because of persistent nonproductive cough for 2 months. He has not had orthopnea or paroxysmal nocturnal dyspnea. He has not had chest pain. He has hypertension treated with ramipril for the past 3 months. He does not smoke. His pulse is 100/min and regular, respirations are 20/min, and blood pressure is 170/75 mm Hg. Cardiac examination shows a displaced apex beat. An ECG shows left ventricular hypertrophy. Ramipril is ceased. The most appropriate next step in management is administration of which of the following?