Intravenous nitroglycerin in acute coronary artery disease

Intravenous nitroglycerin (IVNG) was used in 12 instances (11 patients) to relieve pain, following myocardial infarction or unstable angina. The strength of IVNG infusion could be easily controlled and relief of pain was prompt and satisfactory. Excessive tachycardia or severe headache was not encountered and marked hypotension was seen in one patient only. This patient had three vessel coronary artery disease, extensive myocardial damage and vein graft closure. Cardiovascular stability was provided by IVNG, prior to and during cardiac catheterisation and cineangiography, transportation to another hospital and vein graft surgery. IVNG appears to be a safe and effective drug in the management of patients with acute coronary artery disease (unstable angina and myocardial infarction). In those with both right and left ventricular wall infarction, however, the usefulness of IVNG needs to be established.