Keys of Treatment of Acute Aortic Dissection

The Goal of Treatment :-

• Reduces the Force of Cardiac Contraction

• Reduces Rate of Rise of Aortic pressure (dP/dt)

• Retards Propagation of Dissection and

• Delays Aortic Rupture.

🌀Target of Acut Treatment

👉Target Heart Rate should be

60 - 80 beats per minute.

👉Target Systolic Blood Pressure should be

100 - 120 mm Hg.


💢To Reduce dP/dt Acutely:-

Administer IV beta blocker in incremental doses

Uٓntil a HR of 60-80 is attained.

💢Consider Calcium channel blockers

When Beta Blockers are Not available or

contraindicated, such as in advanced AV Block

💢Beta-blockers should be used cautiously

with Aortic Regurgitation because

they will block compensatory tachycardia


🎯To Reduce Arterial Pressure Acutely :-

Sodium Nitroprusside is effective and potent Vasodilator

🎯Vasodilator therapy should not be initiated

prior to rate control to avoid associated

reflex tachycardia

🎯ACEI successfully Treats Refractory HTN

associated aortic dissection.


♻️IV Morphine sulfate prevent exacerbations of

Tachycardia and HTN

♻️Stanford classification delineate treatment

• Type A (Ascending Ao) requires Surgical ttt

• Type B does not involve-requires Medical ttt

♻️Before administering Thrombolytics

Checking blood pressures in both arms and

listening for carotid bruits also can help to

Exclude aortic dissection