A 75-year-old male presents to the emergency department with a several-hour

A 75-year-old male presents to the emergency department with a several-hour historical past of again ache in the interscapular area. His medical historical past contains a earlier myocardial infarction (MI) a number of years in the past, a historical past of cigarette smoking till the time of the MI, and hypertension that’s effectively managed with hydrochlorothiazide and lisinopril (Prinivil, Zestril). The affected person seems anxious, however all pulses are intact. His blood strain is 170/110 mm Hg and his pulse fee is 110 beats/min. An EKG exhibits proof of an previous inferior wall MI however no acute modifications. A chest radiograph exhibits a widened mediastinum and a regular aortic arch, and CT of the chest exhibits a dissecting aneurysm of the descending aorta that’s distal to the proximal stomach aorta however doesn’t contain the renal arteries. Which certainly one of the following could be the most applicable subsequent step in the administration of this affected person?

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