ST elevation myocardial infarction calcium channel blocker therapy

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

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Guidelines (DO NOT EDIT)

  • Class IIa

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)

  • Class III

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)


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