A 40-year-old male is suspected of having an aortic dissection. His blood pressure is 230/130 mmHg. He is in severe pain. The pre-hospital team has IV...

Question

A 40-year-old male is suspected of having an aortic dissection. His blood pressure is 230/130 mmHg. He is in severe pain. The pre-hospital team has IV access. In addition to IV morphine for analgesia, what is the target heart rate for blood pressure management and why?

Accepted Answer

Target heart rate below 60 bpm using IV beta-blockers (labetalol or esmolol) - reducing heart rate decreases the rate of rise of aortic pressure (dP/dt), which is the primary driver of aortic wall shear stress and dissection propagation

Answer

Target heart rate below 100 bpm - any reduction is sufficient

Answer

Heart rate control is not important - only systolic blood pressure matters

Answer

Increase the heart rate to improve cardiac output

Answer

Target heart rate below 80 bpm using IV verapamil

uk-dipimc MCQ (SBA): Aortic Dissection - Heart Rate Target

A 40-year-old male is suspected of having an aortic dissection. His blood pressure is 230/130 mmHg. He is in severe pain. The pre-hospital team has IV access. In addition to IV morphine for analgesia, what is the target heart rate for blood pressure management and why?