Beta Blockers precipitates AV block in Inf Wall MI

Beta Blockers precipitates AV block in Inf Wall MI

Beta-blockers are generally considered beneficial in the management of acute myocardial infarction (MI), including inferior wall MI. They help reduce myocardial oxygen demand, suppress arrhythmias, and improve survival following MI. However, there are some considerations regarding their use in the context of inferior wall MI:

  1. Bradyarrhythmia: Beta-blockers can indeed reduce heart rate, and in some cases, they may exacerbate or unmask preexisting atrioventricular (AV) block, especially in patients with inferior wall MI where the AV node’s blood supply may be compromised. Therefore, caution is needed when initiating beta-blockers in patients with suspected or known AV conduction abnormalities. Monitoring for bradycardia and AV block is essential in these patients.
  2. Hypotension: Beta-blockers can cause systemic vasodilation and decrease in blood pressure. In patients with inferior wall MI, especially if there is right ventricular involvement, there may already be compromised cardiac output, and beta-blockers can exacerbate hypotension. Therefore, careful assessment of blood pressure and cardiac function is necessary before initiating beta-blockers.

While beta-blockers are generally beneficial in reducing mortality and improving outcomes following MI, their use should be individualized based on the patient’s clinical presentation, hemodynamic status, and potential contraindications or complications such as significant bradycardia or hypotension. In some cases, alternative medications or temporary pacing may be considered to manage bradycardia or AV block while optimizing myocardial perfusion and reducing the risk of complications.