Cardiac Medicine Certification (CMC) Practice Exam

Which medication is considered a first-line treatment option for chest pain in a myocardial infarction patient?

1. Aspirin

2. Nitroglycerin sublingually

3. Metoprolol

4. Morphine sulfate

The correct answer is: Nitroglycerin sublingually

The first-line treatment option for chest pain in a myocardial infarction patient is nitroglycerin sublingually. Nitroglycerin works by dilating the coronary arteries, thereby improving blood flow to the heart muscle that is not receiving adequate oxygen due to the blockage. This vasodilation effectively reduces the myocardial oxygen demand and can relieve pain associated with ischemia quickly. Administering nitroglycerin sublingually allows for rapid absorption through the mucous membranes, leading to a quicker onset of action compared to oral tablets. This feature is particularly critical in acute settings, where time is of the essence. In the context of managing chest pain during a myocardial infarction, alleviating the discomfort swiftly can also help stabilize the patient and facilitate further interventions. While aspirin is beneficial for its antiplatelet properties and is often administered during a myocardial infarction to prevent clot propagation, it primarily addresses the underlying cause rather than directly alleviating pain. Metoprolol is useful for reducing heart rate and myocardial oxygen demand, but it is not the first-line agent for immediate pain relief. Morphine sulfate may be used if pain is severe and not responsive to nitroglycerin, but it can cause hypotension and respiratory depression, making it less preferable