American Board of Internal Medicine (ABIM) Certification Practice Exam

What does β-blockade help manage in acute aortic injury?

1. Heart rate

2. Blood pressure

3. Cholesterol levels

4. Blood glucose levels

The correct answer is: Blood pressure

In the context of acute aortic injury, particularly conditions like aortic dissection or aortic aneurysm, β-blockade plays a crucial role in managing the cardiovascular response. This management primarily targets blood pressure, which is critical for minimizing further stress on the aortic wall and reducing the risk of complications such as rupture or further dissection. β-blockers work by blocking the action of epinephrine (adrenaline) and norepinephrine on the heart and blood vessels. This leads to a decrease in heart rate and myocardial contractility, ultimately reducing cardiac output. Importantly, they also cause vasodilation, which contributes to lowering systemic vascular resistance and, consequently, blood pressure. By effectively lowering blood pressure, β-blockers help to decrease the shear stress on the aortic wall during a vulnerable state, thereby managing the acute situation more safely. Addressing the other aspects in the choices, while β-blockers do influence heart rate, the primary focus in acute aortic injury management is achieving optimal blood pressure control. Cholesterol levels and blood glucose levels do not directly relate to the immediate management of acute aortic injuries, where the focus is predominantly on stabilizing hemodynamics to prevent progression of the injury. Therefore, in acute aortic