A patient presents with acute chest/back pain and CT shows Stanford type B aortic dissection without rupture or malperfusion. Initial vitals: HR 110 b...

Question

A patient presents with acute chest/back pain and CT shows Stanford type B aortic dissection without rupture or malperfusion. Initial vitals: HR 110 bpm, SBP 170 mm Hg. Best immediate medical therapy?

Accepted Answer

Initiate IV beta-blocker (e.g., esmolol) to target HR 60-80 bpm, then add vasodilator to target SBP 100-120 mm Hg

Answer

Start IV nitroprusside alone to rapidly reduce SBP

Answer

Start IV hydralazine alone to reduce afterload

Answer

Immediate thoracic endovascular repair

Answer

Give IV labetalol bolus then observe without titration

us-abem MCQ (SBA): Aortic Dissection

A patient presents with acute chest/back pain and CT shows Stanford type B aortic dissection without rupture or malperfusion. Initial vitals: HR 110 bpm, SBP 170 mm Hg. Best immediate medical therapy?