Ketamine should be avoided in which condition?

Ketamine should be avoided in which condition?

• A. Hypoxia
• B. Hypertension
• C. Hypotension
• D. Chest pain suggestive of ACS or STEMI

Answer: (D)

Ketamine increases sympathetic activity, which raises heart rate and blood pressure and boosts cardiac output. In chest pain that suggests acute coronary syndrome or STEMI, the heart is already stressed trying to meet oxygen demand, so any drug that raises heart rate and blood pressure can worsen myocardial ischemia, potentially increasing infarct size or provoking arrhythmias. That’s why ketamine should be avoided in ACS/STEMI. In other situations, like hypoxia where airway reflexes and bronchodilation are valuable, ketamine can be more appropriate, but the risk in ACS is the key reason for not using it.

Ketamine increases sympathetic activity, which raises heart rate and blood pressure and boosts cardiac output. In chest pain that suggests acute coronary syndrome or STEMI, the heart is already stressed trying to meet oxygen demand, so any drug that raises heart rate and blood pressure can worsen myocardial ischemia, potentially increasing infarct size or provoking arrhythmias. That’s why ketamine should be avoided in ACS/STEMI. In other situations, like hypoxia where airway reflexes and bronchodilation are valuable, ketamine can be more appropriate, but the risk in ACS is the key reason for not using it.