Question

A 68-year-old presents within 2 hours of acute right-sided weakness and aphasia. CT head shows no haemorrhage. BP is 198/112 mm Hg. What is the best immediate step to enable IV alteplase?

Accepted Answer

Lower BP below 185/110 mm Hg with IV labetalol

Answer

Proceed with alteplase; BP reduction is not needed

Answer

Start nicardipine to lower BP to <160/90 mm Hg before alteplase

Answer

Give aspirin 325 mg now and observe

Answer

Delay treatment until MRI confirms infarct

Practice question

A 68-year-old presents within 2 hours of acute right-sided weakness and aphasia. CT head shows no haemorrhage. BP is 198/112 mm Hg. What is the best immediate step to enable IV alteplase?