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Old 12-28-2015
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Default #pharmacology#cardiology Question in #usmle

A 35 year old man with a history of Marfan syndrome presents to the emergency room complaining of chest pain radiating to his upper back between shoulder blades. His blood pressure is 170/90 mmHg in his right arm and 90/60 in left arm. His pulse is 98/min. Cardiac examination reveals regular rhythm with diastolic murmur on the left lower sternal border. Lung examination reveals clear bilateral breath sounds. An echocardiogram shows dissection of the thoracic aorta involving the left subclavian artery.
Which of these is the recommended immediate drug of choice?
A- Clopidogrel
B- Heparin
C- Sodium nitroprusside
D- Calcium gluconate
E- Labetalol
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Old 12-29-2015
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labetalol-and all beta blockers best for dissection because the decrease PVR and HR

all anticoagulants contraindicated.

nitroprusside causes reflex tachycardia-not good in this condition.
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