is a 62 year old AA female with hypertension, Type
II insulin-requiring diabetes mellitus, hyperlipidemia
and chronic renal insufficiency. The patient was admitted
to the ED with a 12 hour complaint of new onset intermittent
rest and nocturnal angina. Her BP is 150/90 mm Hg,
pulse is regular at 80/min and respirations are unlabored
at 20/min. There is an S4 gallop at the apex. Lungs
are clear, abdomen is unremarkable and there is no
The serum BUN/Cr are 36/2.4 mg/dl, while the remainder
of the BMP is WNL. CBC is unremarkable and cardiac
enzymes are negative. Chest x-ray shows an uncoiled
aorta and no acute abnormality.
Her EKG demonstrated a sinus mechanism with 2 mm ST
depression in the inferior and lateral leads:
of the following is not indicated in the management
of this patient?