In cases of acute coronary syndrome, which medication should be administered first for chest pain?

In cases of acute coronary syndrome, the administration of nitroglycerin is commonly the first response for managing chest pain. Nitroglycerin is a vasodilator that facilitates the dilation of coronary arteries, which improves blood flow to the heart muscle. This mechanism helps alleviate chest pain (angina) caused by reduced blood flow due to narrowed arteries or blockages.

While other medications like beta-blockers, anticoagulants, and aspirin play crucial roles in the overall management of acute coronary syndrome, they are typically used in conjunction with nitroglycerin rather than as immediate first-line treatments for chest pain. Beta-blockers help decrease heart workload and oxygen demand, anticoagulants prevent clots from forming or growing, and aspirin reduces platelet aggregation to help prevent further clot development. However, they do not provide immediate relief from the symptoms of chest pain as effectively as nitroglycerin does.

Therefore, in acute situations where the priority is to relieve chest pain quickly, nitroglycerin is the medication of choice.