Before administering nitroglycerin for chest pain, which pre‑administration check is essential?

Before administering nitroglycerin for chest pain, which pre‑administration check is essential?

• A. Systolic blood pressure must be above 100 mmHg
• B. Heart rate must be below 60 beats per minute
• C. There is no history of erectile dysfunction
• D. The patient has eaten within the last two hours

Answer: (A)

Before giving nitroglycerin for chest pain, the most important check is the patient’s systolic blood pressure. Nitroglycerin dilates veins and arteries, which lowers preload and afterload and can significantly drop blood pressure. If the systolic pressure is too low, further reduction could compromise perfusion to the heart and brain, potentially causing fainting or worsened ischemia. A systolic reading above about 100 mmHg is a safe threshold to proceed, reflecting adequate perfusion reserve. The other checks listed aren’t required prerequisites for nitroglycerin administration: heart rate alone isn’t a gating factor, a history of erectile dysfunction isn’t a direct contraindication (though concurrent use of certain ED medications is important in broader safety), and recent meals don’t affect the decision to administer sublingual nitro.

Before giving nitroglycerin for chest pain, the most important check is the patient’s systolic blood pressure. Nitroglycerin dilates veins and arteries, which lowers preload and afterload and can significantly drop blood pressure. If the systolic pressure is too low, further reduction could compromise perfusion to the heart and brain, potentially causing fainting or worsened ischemia. A systolic reading above about 100 mmHg is a safe threshold to proceed, reflecting adequate perfusion reserve. The other checks listed aren’t required prerequisites for nitroglycerin administration: heart rate alone isn’t a gating factor, a history of erectile dysfunction isn’t a direct contraindication (though concurrent use of certain ED medications is important in broader safety), and recent meals don’t affect the decision to administer sublingual nitro.