Question

A 60-year-old with acute tearing chest pain radiating to the back has CTA showing a type B aortic dissection without complications. HR is 102/min and SBP 168/92 mm Hg. What is the best initial therapy?

Accepted Answer

IV esmolol infusion to target HR <60/min and SBP 100-120 mm Hg

Answer

Immediate surgical repair

Answer

Nitroprusside monotherapy to rapidly lower SBP

Answer

High-dose aspirin and observation

Answer

Start oral beta blocker and discharge with follow-up

Practice question

A 60-year-old with acute tearing chest pain radiating to the back has CTA showing a type B aortic dissection without complications. HR is 102/min and SBP 168/92 mm Hg. What is the best initial therapy?