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

IV beta blockers should not be administered to STEMI patients who have any of the following: Class III, Level of Evidence: A


 * 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).