To use GTN or not?

[asc01]

I wonder how other users decide about using GTN?

If my chest pain is exercise-induced, it will go off within five minutes of stopping. It therefore seems there is little point in using GTN. If it is stress-induced it tends to go on for about 15 minutes and I find GTN helps, but my first couple of doses precipitated a headache, although last time it didn't.

I wonder what criteria other users employ?

[huckfinn]

My first cardio, whom is retired now, told me that any amount of angina is damaging to the heart. It sounds like it could be true, so I take fast acting nitro when I suspect I may be having a heart attack, or that my heart is being damaged by ischemia.

Nitro dilates all of the arteries and the ones going to the brain get a "rush of blood" that sometimes causes me to have a very short headache.

I must admit that sometimes the criteria as to use GTN or not is if I can take the headache. If the angina is bad enough, this headache criteria goes out the window

[started04]

The "retired cardio" is probably from the ole school of thought that physical exercise should be avoided for heart patients.

It is true GTN reduces the heart's afterload by relaxing arteries and widen vessels thereby reducing blood volume and this decreases the amount of blood returned to the heart with the end result of less oxygen needed to meet the heart's demand.

Unfortunately, there can develop nitrate tolerance that may require an increase in dosage for the same results. I take isosorbide (slow release of NO) for a period of time and discontinue for a short period. I have used sublingual nitro (fast activation) if and when angina develops...rarely need, no side effects.