Which medication is considered first-line treatment for aortic dissection?

Beta-blockers are considered the first-line treatment for aortic dissection primarily because they effectively reduce heart rate and blood pressure, thereby decreasing the sheer stress on the aortic wall. The management of aortic dissection focuses on mitigating the force exerted on the aorta to prevent further tearing and complications, and beta-blockers accomplish this by negatively impacting the inotropic and chronotropic properties of the heart.

In cases of aortic dissection, it is crucial to control the heart rate immediately to limit the progression of the tear. By doing so, beta-blockers provide the necessary hemodynamic stability. They allow for better control of blood flow dynamics, which is key in managing these critical patients. Additionally, they have been shown to improve outcomes in aortic dissection scenarios when initiated early.

The other medications listed may play a role in specific contexts but are not the primary treatment. For instance, while vasodilators can lower blood pressure, their use may lead to compensatory tachycardia, which could worsen the dissection. ACE inhibitors and calcium channel blockers are generally not used as first-line treatments for this condition due to their differing mechanisms of action and potential side effects, which do not provide the immediate heart rate and pressure control that