Question

A 66-year-old with acute ischemic stroke last known well 2 hours ago has BP 198/112 mm Hg and no contraindications. What is the next best step to enable IV alteplase?

Accepted Answer

Lower BP to <185/110 mm Hg (e.g., IV labetalol) and then give alteplase

Answer

Give nicardipine after alteplase is started

Answer

Proceed with alteplase now; BP will fall after treatment

Answer

Start labetalol only if BP exceeds 220/120 mm Hg

Answer

Observe for 30 minutes then recheck BP

Practice question

A 66-year-old with acute ischemic stroke last known well 2 hours ago has BP 198/112 mm Hg and no contraindications. What is the next best step to enable IV alteplase?