Dyspnea and abdominal pain—how would you manage this patient?

A 66-year-old male with a history of hypertension presents to the emergency department with dyspnea and sharp abdominal pain radiating to his back. On examination, his blood pressure is 180/120 mm Hg. A CT scan demonstrates the findings seen here and laboratory testing indicates that his renal function is preserved. Which of the following is the most appropriate next step given this patient’s likely diagnosis?

A. Embolization
B. Antihypertensive therapy
C. Surgical repair
D. Thrombolytic therapy

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Figure 1

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