🏥 USMLE Exam Prep

A 68-year-old male with a history of hypertension and hyperlipidemia presents with sudden, excruciating tearing chest pain radiating to his back. His blood pressure is 180/110 mmHg in the right arm and 160/90 mmHg in the left arm. A CTA chest confirms acute aortic dissection involving the ascending aorta. What is the immediate pharmacological goal?

A Aggressive blood pressure lowering with IV hydralazine
B Heart rate and blood pressure control with IV labetalol
C Anticoagulation with unfractionated heparin
D Pain control with oral ibuprofen

✓ Correct Answer: Option B

In acute aortic dissection, the immediate goal is to rapidly reduce both heart rate and blood pressure to decrease aortic shear stress. Beta-blockers like labetalol or esmolol are preferred for their dual effect on heart rate and blood pressure.

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