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Patient groups with chronic heart failure who should not be prescribed beta blockers

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Patient groups with chronic heart failure who shouldn't be prescribed a beta-blocker (1):

  • contra-indicated in patients who have asthma with reversible airways obstruction - note however that most patients with chronic obstructive pulmonary disease (chronic bronchitis and emphysema) do not have much reversible airways obstruction and can be given beta-blockers safely
    • if in doubt, pulmonary function testing should be undertaken
  • peripheral vascular disease
    • most patients with peripheral vascular disease can be given beta-blockers safely, however they are contraindicated in critical limb ischaemia
  • beta-blockers should not be given to patients with decompensated heart failure and patients should be free of signs of fluid retention prior to commencement
  • beta-blockers should not be given to patients requiring intensive care for their heart failure in an ICU or when they are on inotropes
  • heart block
    • patients with second or third degree heart block should receive a pacemaker before beta-blockers are prescribed

Reference:

  1. British Heart Foundation. Factfile 4/06 - Use of beta blockers in heart failure.

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