Question

A 56-year-old woman with poorly controlled hypertension presents with tearing chest pain radiating to the back. Blood pressure is 210/110 mmHg. CT angiography confirms a Stanford type A aortic dissection. What is the most appropriate immediate blood pressure and heart rate management?

Accepted Answer

Rapidly lower systolic BP to <100 mmHg and HR <60 bpm using IV beta-blocker and vasodilator while arranging emergent surgery

Answer

No blood pressure control is needed

Answer

Use vasodilator alone without beta-blocker

Answer

Aim for systolic BP <180 mmHg only

Answer

Delay blood pressure control until after surgery

Practice question

A 56-year-old woman with poorly controlled hypertension presents with tearing chest pain radiating to the back. Blood pressure is 210/110 mmHg. CT angiography confirms a Stanford type A aortic dissection. What is the most appropriate immediate blood pressure and heart rate management?