Intravenous nitroglycerin for acute myocardial infarction.

Intravenous nitroglycerin (IV TNG) has been increasingly used in the setting of acute myocardial infarction. The seven randomized trials comparing IV TNG with placebo, and one trial comparing IV isosorbide dinitrate with furosemide, were reviewed for evidence of beneficial clinical effects. IV TNG in low dosage is safe in the setting of acute myocardial infarction and modestly effective in relieving chest pain. Favorable hemodynamic effects are most pronounced in patients with congestive heart failure. Limited evidence suggests that IV TNG, particularly when administered early, reduces both infarct size and mortality when given prophylactically.