Question

A 70-year-old presents within 2 hours of last-known-well with right hemiparesis and aphasia. BP 188/106 mm Hg, noncontrast CT negative. Next best step to enable alteplase?

Accepted Answer

Lower BP to <185/110 with IV labetalol then administer alteplase

Answer

Proceed with alteplase at current BP

Answer

Lower BP to <140/90 then give alteplase

Answer

Antiplatelet therapy now and admit; tPA outpatient

Answer

Give heparin infusion while awaiting MRI

Practice question

A 70-year-old presents within 2 hours of last-known-well with right hemiparesis and aphasia. BP 188/106 mm Hg, noncontrast CT negative. Next best step to enable alteplase?