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Nitroglycerin: Should We Still Ask?

Raymond J. Gibbons, MD
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From Mayo Clinic/Mayo Foundation; Rochester, MN 55905.

Requests for Single Reprints: Raymond J. Gibbons, MD, Mayo Clinic, 200 First Street SW, Gonda 5-412, Rochester, MN 55905.

Ann Intern Med. 2003;139(12):1036-1037. doi:10.7326/0003-4819-139-12-200312160-00014
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Clinicians have long used the response to sublingual nitroglycerin for diagnostic and prognostic purposes in a variety of settings. In stable outpatients with chest pain, pain relief by nitroglycerin has been 1 of 3 components of the most commonly used definition of typical angina (12). In acutely ill patients who present to the hospital, relief of chest pain at rest with nitroglycerin has been assumed to indicate a cardiac cause of the pain. In acutely ill patients with ongoing myocardial ischemia, failure of chest pain to respond to sublingual nitroglycerin is believed to indicate a more severe problem with a higher risk for early adverse events.



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