Which of the following is not a contraindication to therapy with β-blockers in acute coronary syndrome?

In the context of acute coronary syndrome, β-blockers are commonly used to reduce heart rate, decrease myocardial oxygen demand, and improve hemodynamics. However, certain conditions pose contraindications for their use.

Stable angina, on the other hand, is characterized by predictable chest pain that occurs with exertion and is usually relieved by rest or nitroglycerin. It reflects a condition where the heart muscle is not receiving enough oxygen due to narrowed coronary arteries, but it is not an acute or life-threatening situation like the others listed. The use of β-blockers in patients with stable angina is generally beneficial as they help manage symptoms and reduce the risk of future anginal episodes.

In contrast, low cardiac output, risk for cardiogenic shock, and acute heart failure represent more severe and unstable cardiovascular conditions where β-blockers could exacerbate the situation by further reducing cardiac output and potentially leading to worse outcomes. Therefore, the use of β-blockers in these instances is contraindicated.

Understanding the rationale for when β-blockers are appropriate can greatly influence management strategies in acute situations, emphasizing the importance of distinguishing between stable conditions and those that indicate a need for caution in pharmacological treatment.