Ketamine should not be given to patients with which condition?

• A. Chest pain/ suspected ACS or STEMI protocols
• B. Bronchospasm due to asthma
• C. Uncontrolled hypertension
• D. Severe penicillin allergy

Answer: (A)

Ketamine's sympathetic stimulation raises heart rate and blood pressure, increasing myocardial oxygen demand. In patients with chest pain or suspected acute coronary syndrome (ACS) or STEMI, this extra workload can worsen ischemia and potentially worsen outcomes. That hemodynamic effect is why ketamine should not be given in ACS scenarios. The other situations aren’t outright contraindications—ketamine’s bronchodilatory effect can help in asthma-related bronchospasm, uncontrolled hypertension is a caution due to blood pressure rise, and a severe penicillin allergy is unrelated to ketamine use.