Nitroglycerin may provide relief in which conditions?

• A. Acute coronary syndrome only
• B. GI-induced chest pain only
• C. Both acute coronary syndrome and GI-induced chest pain
• D. Neither

Answer: (C)

Nitroglycerin helps chest pain by two related actions: it dilates veins to drop preload and wall stress, which lowers myocardial oxygen demand, and it relaxes smooth muscle. In acute coronary syndrome, this combination reduces the heart’s oxygen needs and can relieve ischemic chest pain. It also relaxes smooth muscle in the esophagus, so esophageal spasm or other GI-origin chest pains driven by smooth muscle clamping can improve with nitroglycerin. Because of these two effects, nitroglycerin can provide relief in both ACS-related angina and GI-induced chest pain, making the best answer that it may help in either scenario.