The Living Guidelines: STEMI Recommendations for Additional Management Considerations for Beta Blocker Therapy View the Current CLASS IIa Guidelines

It is reasonable to administer an IV beta blocker at the time of presentation to STEMI patients who are hypertensive and who do not have any of the following: Class IIa, Level of Evidence: B


 * Signs of heart failure,


 * Evidence of a low output state,


 * Increased risk for cardiogenic shock are age >70 years, systolic blood pressure <120 mm Hg, sinus tachycardia >110 bpm or heart rate <60 bpm, and increased time since onset of symptoms of STEMI (the greater the number of risk factors present, the higher the risk of developing cardiogenic shock),


 * Other relative contraindications to beta blocker therapy (PR interval >0.24 seconds, second or third degree AV block, active asthma, or reactive airway disease).