Ruling out vasospastic angina at bedside

Ruling out vasospastic angina at bedside

Using nitroglycerine, especially for suspected anterior wall infarction may be useful in excluding vasospastic angina. Prompt resolution of ST segment elevation with relief of pain would indicate vasospastic angina. But, the same strategy applied in inferior wall infarction may cause hypotension and bradycardia and should be cautiously used or better avoided. May be we will not need these modalities now with availability of bedside echocardiography and rapid troponin estimation at point of care itself.