Review Question - QID 214496

A 67-year-old man presents to his primary care doctor due to concerns about his ability to have an erection. He states that after he had his heart attack 1 month ago he has been unable to achieve an erection. He finds his wife sexually attractive and would like to engage in intercourse. The patient states that he is taking multiple medications that were started after the heart attack. He feels guilty that he cannot engage in intercourse with his wife and has had a depressed mood as a result. He admits to having less energy lately and is less interested in working on his motorcycle, a hobby he previously enjoyed. His temperature is 98.0°F (36.7°C), blood pressure is 152/99 mmHg, pulse is 87/min, respirations are 14/min, and oxygen saturation is 98% on room air. Physical exam reveals an obese man. His external genitalia appears normal, and his dorsalis pedis and posterior tibial pulses are 1+. He has a stable gait and normal strength and sensation throughout. Which of the following is the most likely etiology of this patient’s symptoms?