Does Relief of Chest Pain with Nitro Have Diagnostic Value?

When chest pain is relieved by nitroglycerin, we usually assume that the probability of coronary disease is high. However, results of a recent study suggested that response to nitroglycerin does not discriminate between cardiac and noncardiac chest pain in an emergency department (ED) setting (Journal Watch Cardiology Feb 13 2004).

In this new study, researchers at a California ED assessed responses to nitroglycerin in consecutive patients with chest pain. All patients rated pain on a 0–10 scale before they received sublingual nitroglycerin and again 5 minutes afterward. Depending on the magnitude of change in the pain score, pain relief was categorized as none, minimal, moderate, or significant/complete. Pain was diagnosed eventually as car…