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sabicool/12.11.24-06:47AM
Rejected at: Jan, 27, 2025
10:23 a.m.
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sabicool
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1675118865074
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What is the preferred pharmacological management for hypertensive emergency due to an aortic dissection?
{{c1::β-blocker (preferably esmolol) slowly until pulse 60-80bpm}}
{{c1::± IV infusion of sodium nitroprusside or glyceryl trinitrate::if refractory}}
{{c1::β-blocker (preferably esmolol) slowly until pulse 60-80bpm}}
{{c1::± IV infusion of sodium nitroprusside or glyceryl trinitrate::if refractory}}
Extra
Use an intravenous infusion of a beta blocker to slowly reduce the heart rate to below 60 beats per minute, followed by an intravenous infusion of sodium nitroprusside or glyceryl trinitrate, titrating the dose to achieve a systolic BP of around 100 mmHg. It is important to give a beta blocker before giving a vasodilator, as tachycardia can occur if the vasodilator is given first.
Sodium nitroprusside or GTN infusion should be given with ICU level care and intra-arterial BP monitoring
Sodium nitroprusside or GTN infusion should be given with ICU level care and intra-arterial BP monitoring
Personal Notes
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Missed Questions
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Oxford Handbook
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First Aid
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AMBOSS
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eTG Complete





Talley & O'Connor
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Additional Resources
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Source
eTG - Urgent control of elevated blood pressure https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Cardiovascular&topicfile=c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1&guidelinename=auto§ionId=c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1#c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1 Published June 2023, Accessed 19 October 2024
FRCEM AFTBAFFF, FFSEM MCMMbcF, FACEM ACMMc. Marshall & Ruedy’s On Call: Principles & Protocols. 3rd edition. Elsevier; 2016. 648 Chapter 16: Chest Pain p. 117
Emergency Care Institute Aortic Dissection https://aci.health.nsw.gov.au/networks/eci/clinical/tools/cardiology/aortic-dissection
FRCEM AFTBAFFF, FFSEM MCMMbcF, FACEM ACMMc. Marshall & Ruedy’s On Call: Principles & Protocols. 3rd edition. Elsevier; 2016. 648 Chapter 16: Chest Pain p. 117
Emergency Care Institute Aortic Dissection https://aci.health.nsw.gov.au/networks/eci/clinical/tools/cardiology/aortic-dissection
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Tags
#Malleus_CM::#eTG_Complete::Cardiovascular::Blood_pressure_reduction::Urgent_control_of_elevated_blood_pressure
#Malleus_CM::#Resources_by_Rotation::Internal_Medicine::Cardiology
#Malleus_CM::#Resources_by_Rotation::Surgery::Vascular
#Malleus_CM::#Subjects::Cardiology::13_Vascular_Pathology::Aorta::Aortic_Dissection::10_Management
#Malleus_CM::#Subjects::Surgery_&_EM::05_Vascular_Surgery::01_Arterial_Disease::Aortic_Dissection::10_Management
#Malleus_CM::#Textbooks::05_Marshall_&_Ruedy's_On_Call:_Principles_&_Protocols_ANZ_3e::Section_C_Common_Calls::16_Chest_pain
#Malleus_CM::#Textbooks::05_Marshall_&_Ruedy's_On_Call:_Principles_&_Protocols_ANZ_3e::Section_C_Common_Calls::19_Hypertension