Intravenous Nitroglycerin in Acute Myocardial Infarction

It is generally recognized by clinicians that nitroglycerin (NG) should be used with caution in acute myocardial infarction (AMI) because of the danger of hypotension and reflex tachycardia. In fact, Prodger [1] in 1932, and later Friedberg [2] in 1966, warned against its use in AMI for those reasons. In the mid 1970s, when intravenous NG was being used in early AMI to improve left ventricular function and salvage ischemic myocardium [3–5], an attempt was made to titrate the dose to a discrete hemodynamic end point and avoid hypotension.