• Older male patient with tearing chest pain radiating to the pack, different upper extremity blood pressures, aortic regurgitation murmur and a widened mediastinum on CXR, all of which are consistent with aortic dissection
• Key idea: Beta-blockers (such as labetalol) are particularly useful in setting of aortic dissection because the force of blood being ejected from the LV and hitting the aorta can further propagate the tear, with beta blockers leading to reduced contractility and reduced force of blood ejection against the aorta

https://step-prep.org/tutoring/

priority for AD patients is rate control. After controlling rate you can throw on something extra for pressure control but rate control comes first.

Beta blockers first, to avoid reflex tachcardia from other vasodilating IV anti-hypertensives.