When are nitrates contraindicated in patients with symptoms of acute coronary syndrome (ACS)?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Nitrates should not be used in patients presenting with marked hypotension or bradycardia, or if there is suspicion of right ventricular infarction.

Special attention should be made in taking the history of whether concomitant use of phosphodiesterase (PDE) inhibitors (eg, sildenafil) has occurred within the last 24 to 72 hours, because this drug combination may lead to life-threatening hypotension.


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