1945benefit from both beta-blockade and ACE inhibition. However, his blood pressure was typically only 110/70 mm Hg, so only one agent could be administered, and given the frequent ventricular ectopy, his doctors elected to treat with a low dose of metoprolol succinate. Dudzinski and Schrager ask readers to keep in mind the varied presentations of polyarteritis nodosa. A more exhaustive differential diagnosis for this patient would include polyarteritis nodosa, since it can result in both renal and myocardial infarction. However, this patient had no cutaneous lesions or neuropathy, 3 had sinus bradycardia rather than tachycardia, and was found on angiography to have only "a subtle irregularity" of the midportion of the left anterior descending coronary artery; there was no evidence of aneurysms, obstruction, nodularity, dissection, or thrombosis, which would suggest polyarteritis nodosa. Moreover, since the left ventricular apical aneurysm did not appear to be consistent with a myocardial infarction, it seemed unlikely that the aneurysm was the result of vasculitis or other pathology of the coronary artery. Therefore, although the diagnosis of polyarteritis nodosa could not be formally excluded, it seemed insufficiently likely to warrant discussion, particularly in view of the limited space available in the article.

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