Agents recommended in treatment of aortic dissection are all except
**Core Concept**
Aortic dissection is a serious medical condition characterized by the tearing of the inner layer of the aorta, potentially leading to catastrophic complications such as rupture or malperfusion of vital organs. Management of aortic dissection involves controlling blood pressure, heart rate, and cardiac output to prevent further dissection or rupture.
**Why the Correct Answer is Right**
Diazoxide is a vasodilator that can worsen aortic dissection by increasing the shear stress on the aortic wall. In contrast, beta blockers (A) and labetalol (B) are recommended to control heart rate and reduce blood pressure, which helps to decrease the force of ejection and subsequently reduce the risk of further dissection. Sodium nitroprusside (C) is a potent vasodilator that can be used in conjunction with beta blockers to control blood pressure. However, it should be used with caution to avoid hypotension.
**Why Each Wrong Option is Incorrect**
**Option A:** Beta blockers are recommended in the treatment of aortic dissection to control heart rate and blood pressure, thereby reducing the risk of further dissection.
**Option B:** Labetalol is a mixed alpha and beta blocker that is often used in the management of aortic dissection to control blood pressure and heart rate.
**Option C:** Sodium nitroprusside is a potent vasodilator that can be used in conjunction with beta blockers to control blood pressure in patients with aortic dissection.
**Clinical Pearl / High-Yield Fact**
In the management of aortic dissection, it is essential to remember the "BEACH" principle: Beta blockers for heart rate control, Esmolol for rapid beta blockade, Aortic valve assessment, Catecholamine avoidance, and Hypotension prevention. This mnemonic can help clinicians remember the key components of managing aortic dissection.
**β Correct Answer: D. Diazoxide**