Which medication is contraindicated in the presence of STEMI with hypotension?

In the context of STEMI (ST-Elevation Myocardial Infarction) with hypotension, nitroglycerin is contraindicated due to its vasodilatory effects. While nitroglycerin is commonly used to relieve chest pain and reduce myocardial oxygen demand by causing dilation of coronary arteries, its ability to lower blood pressure can exacerbate hypotension, which is particularly critical during a STEMI event.

When a patient is hypotensive, maintaining adequate blood pressure is essential to ensure sufficient perfusion to vital organs, especially the heart. Administering nitroglycerin in this scenario could lead to a further decrease in blood pressure, increasing the risk of inadequate perfusion and potential worsening of the patient's condition.

Other medications mentioned, such as aspirin, beta-blockers, and anticoagulants, have roles in the management of STEMI and are typically not contraindicated in hypotension, as they work to stabilize the condition and prevent complications rather than directly lowering blood pressure.