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?
C- Sodium nitroprusside
D- Calcium gluconate
This is a typical presentation of aortic dissection. Labetalol is an alpha and beta adrenergic antagonist. It is the recommended drug of choice in this case. Sodium nitroprusside is contraindicated as its mechanism of action is dilation of blood vessels which could worsens the case.
The correct answer is E