Nitroglycerin and Chest Pain

[pspressman]

I don't know if I was ever specifically told that relief of chest pain with nitroglycerin was indicative of coronary artery disease.  However, the belief crept insidiously into my brain, perhaps due to the frequent correlation between nitroglycerin relief and CAD on exams.  Turns out, there's no association between relief of chest pain with nitroglycerin and the diagnosis of CAD: in fact, a greater percentage of patients whose chest pain was relieved with NG had noncardiac than cardiac reasons for their pain.   NG relieved pain in 35% of the patients who were later found to have CAD and in 41% of the patients who did not.


Articles
Chest Pain Relief by Nitroglycerin Does Not Predict Active Coronary Artery Disease
Charles A. Henrikson, Eric E. Howell, David E. Bush, J. Shawn Miles, Glenn R. Meininger, Tracy Friedlander, Andrew C. Bushnell, AND Nisha Chandra-Strobos