When are beta blockers contraindicated in the treatment of non-ST-elevation acute coronary syndrome (unstable angina and NSTEMI)?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Beta blockers should not be given intravenously in patients with evidence of low cardiac output state (heart rate >110 beats/min or systolic blood pressure 96</ref> These agents should also not be given to patients who have a contraindication to beta blockers (eg, first-degree heart block with a PR interval >240 ms, second- or third-degree heart block without a cardiac pacemaker, recent cocaine use, severe/advanced active reactive airway disease).

In patients with chronic obstructive lung disease or chronic asthma, beta-1 selective beta blockers are preferred and should be initiated at low doses.


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