What typically relieves stable chest pain?

• A. Exercise
• B. Rest or nitroglycerin
• C. Caffeine
• D. Cold compress

Answer: (B)

Relief of stable chest pain comes from reducing the heart’s oxygen demand and improving blood supply to the heart muscle. Rest lowers heart rate and blood pressure, which decreases how hard the heart has to work and often stops the ischemia that causes angina. Nitroglycerin works quickly because it releases nitric oxide, leading to venodilation that reduces preload and left ventricular wall stress, thereby lowering myocardial oxygen demand; it can also help dilate coronary arteries to improve blood flow to ischemic areas. Because of this combination, rest or nitroglycerin is typically what relieves stable chest pain.

Exercise would usually worsen the pain by increasing oxygen demand. Caffeine can stimulate the heart and raise oxygen demand, potentially aggravating symptoms. A cold compress doesn’t affect coronary blood flow or myocardial oxygen balance, so it wouldn’t relieve angina.