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Use of nitroglycerin in chest pain - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   Hi
Doctor :   How can I help you?
User :   How does one determine whether to give nitroglycerin to a a female pt with severe chest pain?
Doctor :  
Nitroglcerine will work only if
Doctor :  
the cause of such a pain is an angina
Doctor :  
so first you have to know whether the
Doctor :  
female has a history of heart disease
Doctor :  
or that she is at risk for an angina or heart attack
Doctor :  
The classical signs of of a heart attack
Doctor :  
include weakness, fatigue,
Doctor :  
tightness, squeezing, pressure, or fullness in the chest
Doctor :   accompanied by extreme sweating, shortness of breath, fatigue, chills, nausea and vomiting, anxiety, paleness, or cyanosis, a bluish discoloration of the lips, feet and hands
User :   OK, so if you felt the patient was having an MI, you would not give nitroglycerin?
Doctor :   I would give
User :   I am a medical transcriptionist of many years, and I was watching a program lately where an
User :   EMT gave nitro and he was chastized for this. I was really surprised, because I thought
User :   one would do that as a prophylactic. They said something about if the patient was having an MI it would cause some kind of "cascade" that might not be able to be stopped. Transcriptionists are always interested in this kind of stuff! :)
Doctor :  
Yes, I think I
Doctor :  
know what must have happened
Doctor :  
at the EMT
Doctor :  
Every drug that is used today
Doctor :  
has its own dreaded adverse effect
Doctor :  
so there is also a list
Doctor :  
of contraindications to each of these
Doctor :  
I guess you knew this?
Doctor :  
Ok
Doctor :  
So before administering
Doctor :  
nitroglycerine one is supposed
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to screen the patient quickly
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for such contraindications
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if one hasn't
Doctor :   then it could prove fatal to the patient
Doctor :  
This could happen even if you have missed to notice just one such contraindication!
User :   What a lot of responsibility for doctors. Thank you so much for this information.
User :   Is there a name for that "cascade?
Doctor :  
Your welcome
Doctor :  
I am not aware of any name for the cascade
Doctor :  
what happens
Doctor :  
is that this drug causes
Doctor :  
hypotension
Doctor :  
due to which in particular
Doctor :  
patients, there is peripheral pooling of blood
Doctor :  
& the heart which is already strained
Doctor :  
is forced to pump against the newly created pressure
User :   Now I understand it well. Thank you again. Have a lovely
User :   weekend.
Doctor :  
A cardiologist
Doctor :  
could offer you a better explanation though
Doctor :  
Thanks for consulting me. Bye for now. Please refer your friends to our service.
User :   I will!
Doctor :   Bye
Question is related to
Diseases and Conditions
Drug/Medication
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