Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
An 18-year-old man comes to the physician 1 week after he had a blood pressure of 140/110 mm Hg during a routine precollege examination. His temperature is 37.1 C (98.7 F), blood pressure is 140/100 mm Hg, pulse is 92/min, and respirations are 12/min. The upper extremities appear to be more muscular than the lower extremities. Radial pulses are normal; femoral, posterior tibial, and dorsalis pedis pulses are decreased. A grade 2/6 systolic murmur is heard over the precordium, anterior chest, and back. An ECG shows left ventricular hypertrophy. Which of the following is the most appropriate next step in management?
A ) Limiting physical activity
B ) Repeat blood pressure measurement in 1 month
C ) Initiate a low-sodium diet and exercise program
D ) Pharmacologic management
E ) Operative treatment
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
should we not take care of the HTN 1st or do we go straight to PCI w/ stent?? on Coarcation?
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
Medication
Medication isn't used to repair coarctation of the aorta, but may be used to control blood pressure before surgery. Although repairing aortic coarctation improves blood pressure, many people will still need to take medication even after a successful surgery. Babies with severe coarctation of the aorta may receive a drug called prostaglandin E. This drug helps keeps the ductus arteriosis open, providing a bypass for blood flow around the constriction, until the coarctation is repaired.
After treatment
The most common long-term complication of coarctation of the aorta is high blood pressure. Although your blood pressure usually lowers after the aortic coarctation has been repaired, it may still remain higher than normal. Occasionally, the segment of the aorta that has been repaired will become weak and bulge (aortic aneurysm) and may eventually rupture. In some cases, the coarctation will recur, possibly even years after treatment
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
same principle applies to Aortic Dissection w/ High BP -- Control BP before using TEE for Dx
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
evryone I need to clarfy this for myself. Is this pt unstable BP wise or Stable, so that he can be taken for surgery or needs control of his Diatolic pressure 1st??
any input is appreciated!!
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
27 poeple viewing this but no answer ?? what up
anyway he's stable and BP w/o any Sx's so yes E is correct
Posts: 3,675,934
Threads: 734,342
Joined:
Sep 2021
Reputation:
5
D ) Pharmacologic management
