Question

A hypertensive patient with suspected acute type A aortic dissection has severe tearing chest pain. BP 190/110 mmHg, HR 115/min. What is the first pharmacologic step?

Accepted Answer

Start IV esmolol infusion to reduce HR <60/min, then add vasodilator if needed

Answer

Start nitroprusside infusion to lower SBP to 100-120 mmHg

Answer

Give IV nicardipine to rapidly lower BP

Answer

Administer IV morphine and observe

Answer

Immediate IV labetalol and nicardipine together

Practice question

A hypertensive patient with suspected acute type A aortic dissection has severe tearing chest pain. BP 190/110 mmHg, HR 115/min. What is the first pharmacologic step?