Which of the following is considered the first-line medication for treating aortic dissection?

The first-line medication for treating aortic dissection is an AV nodal blocking agent like labetalol. This class of medications is critical in the management of aortic dissection because they help to reduce both heart rate and systemic blood pressure, which are crucial factors in minimizing the stress on the aorta.

In aortic dissection, the goal is to lower the hemodynamic forces that contribute to the progression of the dissection. By using an AV nodal blocking agent, which has both beta-blocking and alpha-blocking properties, there is a significant and controlled reduction in cardiac output and the overall workload of the heart, which stabilizes the situation and prevents further dissection.

Calcium channel blockers, while they can also aid in blood pressure management, are not typically the first choice due to their effect primarily on vascular smooth muscle dilation rather than directly addressing the heart rate. ACE inhibitors also don’t act quickly enough to manage the immediate hypertension often seen in acute dissection scenarios and are generally not utilized in this acute setting. Beta-agonists would increase heart rate and cardiac output, thereby worsening the situation in aortic dissection, and are not appropriate for this condition.

This is why the AV nodal blocking agent, particularly