Question

A 45-year-old man presents to the emergency department with a blood pressure of 220/125 mm Hg and headache, visual blurring, and new confusion. Fundoscopy shows bilateral flame haemorrhages and papilloedema. Creatinine is 250 µmol/L (baseline 90). There is no chest pain. Which management strategy is most appropriate?

Accepted Answer

Initiate intravenous antihypertensive therapy to reduce mean arterial pressure by no more than 25% over the first few hours

Answer

Start oral amlodipine and review in clinic within 1 week

Answer

Arrange urgent CT brain but delay antihypertensive therapy until imaging is completed

Answer

Rapidly normalise blood pressure to <130/80 mm Hg within 1 hour using high-dose IV medications

Answer

Discharge after giving a single dose of oral beta-blocker

Practice question