BP control is particularly important where thrombolysis is to be used as the primary reperfusion therapy for a patient with acute myocardial infarction.
A more aggressive approach to blood pressure reduction can be taken with myocardial infarction than with stroke, since the evidence of benefit for aggressive reperfusion is stronger even in the setting of elevated BP.
Intravenous beta blockers are the agents of choice.
The ECG shows ST segment elevation. Click on the ECG to enlarge.