Beta blockers are first line treatment for patients with acute and chronic aortic dissection. In acute dissection, rapidly acting, titratable parenteral agents (such as
esmolol,
propranolol, or
labetalol) are preferred. Vasodilators such as
sodium nitroprusside can be considered for patients with ongoing hypertension, but they should never be used alone, as they generally cause reflex tachycardia.