Question 1

Question

A 45-year-old woman presents to the emergency department with sudden-onset severe tearing chest pain radiating to the interscapular region. Her blood pressure is 178/96 mmHg in the right arm and 142/80 mmHg in the left arm. She is diaphoretic and in moderate distress. A CT angiogram of the chest is obtained and demonstrates an intimal flap involving the ascending aorta, consistent with a Stanford Type A aortic dissection. Based on the imaging findings, which of the following is the most appropriate next step in management?

Accepted Answer

Transfer immediately to the operating room for emergent open surgical repair

Answer

Administer IV labetalol to achieve a target systolic BP of less than 120 mmHg and admit to the ICU for medical management

Answer

Perform urgent coronary angiography to rule out concurrent acute coronary syndrome

Answer

Initiate systemic anticoagulation with unfractionated heparin and arrange endovascular stenting

Answer

Obtain a transthoracic echocardiogram to assess for aortic regurgitation before deciding on management

Transplant medicine — MCQs

Transplant medicine — MCQs

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