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Medical management of blood pressure and heart rate in acute type b aortic dissections: a single quaternary Centre perspective


Tran, Q and Herlihy, D and Tran, V and Puttaswamy, V, Medical management of blood pressure and heart rate in acute type b aortic dissections: a single quaternary Centre perspective, pp. 22-22. ISSN 1742-6731 (2020) [Conference Extract]

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Analgesic and antihypertensive choice in acute type B aortic dissection (TBAD) is still based mainly on personal experience and expert opinion. Objectives: This study examines a patientís course through the emergency department (ED), and choice of analgesia and antihypertensive agents used within an Australian quaternary hospital.


Between May 2012 and February 2019, 43 patients with acute TBAD managed through the ED at Royal North Shore Hospital (RNSH) were retrospectively analysed via the hospital electronic database.


For the 43 patients, 93% had an admission systolic BP over 120 mmHg (mean 160 mmHg) and 93% had a HR over 60 bpm (mean 76 bpm). The mean time to be seen by a MO in ED was 12.3 min with a mean length of stay in ED 303 min. The mean time to CTa was 4 h 17 min. 7 different types of analgesia were prescribed in ED with Morphine being the most common (50%). 13 different types of antihypertensive agents were prescribed in ED of which Metoprolol was most frequently used (36%), followed by Hydralazine (11%) and Prazosin (11%). 46% of patients were prescribed 2 antihypertensive agents and 32% with 3 or more. 77% of these patients were transferred to an ICU from ED. Within the ICU, 12 different antihypertensive agents were used where the agent of choice was IV Metoprolol (21%).


A more standardised approach to the treatment of HR and BP in acute TBAD is imperative in ensuring optimal medical management. This is currently being further analysed though a registry at RNSH.

Item Details

Item Type:Conference Extract
Keywords:emergency, medicine, aortic dissection, blood pressure
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Emergency medicine
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Tran, V (Dr Viet Tran)
ID Code:142103
Year Published:2020
Deposited By:Medicine
Deposited On:2020-12-14
Last Modified:2021-05-21

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