Question

A 64-year-old with acute ischemic stroke presents 2 hours after last-known-well with BP 196/112 mm Hg and no contraindications. What is the most appropriate next step?

Accepted Answer

Lower BP to <185/110 with IV labetalol or nicardipine, then give alteplase

Answer

Proceed with alteplase immediately

Answer

Administer aspirin 325 mg before reperfusion

Answer

Delay any therapy until MRI confirms infarct

Answer

Lower BP to <140/90 before alteplase

Practice question

A 64-year-old with acute ischemic stroke presents 2 hours after last-known-well with BP 196/112 mm Hg and no contraindications. What is the most appropriate next step?