Question

A 66-year-old man with long-standing hypertension presents with sudden tearing chest pain radiating to the back. He is hypertensive with BP 210/110 mmHg, has unequal arm blood pressures and a new early diastolic murmur. What is the most appropriate immediate management?

Accepted Answer

Arrange urgent CT aortogram and start intravenous beta-blocker with blood pressure control while awaiting imaging

Answer

Arrange an outpatient echocardiogram

Answer

Start high-dose oral beta-blocker and review in 1 week

Answer

Give sublingual GTN and discharge

Answer

Prescribe NSAIDs for presumed musculoskeletal pain

Practice question

A 66-year-old man with long-standing hypertension presents with sudden tearing chest pain radiating to the back. He is hypertensive with BP 210/110 mmHg, has unequal arm blood pressures and a new early diastolic murmur. What is the most appropriate immediate management?