Question

A 45-year-old woman presents to the emergency department with a severe headache and nausea. Her blood pressure is 230/128 mm Hg. She is alert and oriented with a normal neurological examination, normal fundoscopy and creatinine 85 µmol/L. ECG and troponin are normal. There is no dyspnoea, chest pain or evidence of acute end-organ damage. What is the most appropriate immediate management strategy?

Accepted Answer

Start oral antihypertensive therapy and arrange close outpatient follow-up within days

Answer

Start intravenous antihypertensives to rapidly lower blood pressure to normal within 1-2 hours

Answer

Administer sublingual nifedipine and discharge if blood pressure falls

Answer

Admit to intensive care unit for continuous arterial line monitoring

Answer

Give no treatment as this represents a normal variant

Practice question