In ACS acute tx, which beta blocker is listed?

• A. Propranolol
• B. Carvedilol
• C. Atenolol
• D. Metoprolol

Answer: (D)

Early beta-blockade in ACS reduces myocardial oxygen demand and helps prevent reinfarction and arrhythmias. Metoprolol is the beta-1 selective blocker that’s typically listed for acute management because it acts mainly on the heart, lowering heart rate and contractility with a lower risk of bronchospasm compared with nonselective agents. It can be given promptly (including IV) to achieve rapid control when there are no contraindications. Propranolol is nonselective, which increases the risk of bronchospasm and other systemic effects in the acute setting. Carvedilol has alpha-blocking activity and is more commonly used chronically, especially in heart failure or post-MMI patients, rather than as the initial acute agent. Atenolol is also beta-1 selective, but metoprolol is the one most consistently emphasized for acute ACS management.