Question

A 56-year-old with tearing chest pain radiating to the back has BP 190/110 mm Hg and a widened mediastinum on CXR. What is the most appropriate immediate blood pressure strategy while arranging definitive imaging?

Accepted Answer

Start IV esmolol first, then add vasodilator if needed

Answer

Start IV nitroprusside alone to rapidly lower BP

Answer

Give IV hydralazine boluses

Answer

Start high-dose nifedipine orally

Answer

Withhold BP control until CT confirms diagnosis

Practice question

A 56-year-old with tearing chest pain radiating to the back has BP 190/110 mm Hg and a widened mediastinum on CXR. What is the most appropriate immediate blood pressure strategy while arranging definitive imaging?