Question

A 67-year-old woman presents to the emergency department with a headache, visual blurring and shortness of breath. Her blood pressure is 230/130 mmHg, heart rate 92 beats/min, and she has bilateral papilloedema and evidence of acute pulmonary oedema on chest X-ray. Which is the most appropriate initial management step?

Accepted Answer

Begin intravenous labetalol infusion and admit to a monitored bed

Answer

Start oral amlodipine and arrange urgent clinic follow-up

Answer

Administer sublingual nifedipine and discharge if blood pressure improves

Answer

Start low-dose ACE inhibitor and review in 48 hours

Answer

Give a bolus of intravenous furosemide only and discharge once breathing improves

Practice question