ST elevation myocardial infarction calcium channel blocker therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Calcium channel blockers can be a reasonable therapy for an ill patient with a STEMI.

2004 ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (DO NOT EDIT)

Class III (Harm)

"1. Diltiazem and verapamil are contraindicated in patients with STEMI and associated systolic LV dysfunction and CHF. (Level of Evidence: A)"

"2. Nifedipine (immediate-release form) is contraindicated in the treatment of STEMI because of the reflex sympathetic activation, tachycardia, and hypotension associated with its use. (Level of Evidence: B)"

Class IIa

"1. It is reasonable to give verapamil or diltiazem to patients in whom beta-blockers are ineffective or contraindicated (e.g., bronchospastic disease) for relief of ongoing ischemia or control of a rapid ventricular response with AF or atrial flutter after STEMI in the absence of CHF, LV dysfunction, or AV block. (Level of Evidence: C)"

Sources

• The 2004 ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction

References

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