Hello everyone! I just have a quick question regarding a patient I was caring for who was admitted to the hospital with CHF and rule out ACS. When I first came on to my shift to assess this patient, she had denied any chest pain or SOB; however, when doing her last set of vitals before shift change, she indicated that she was having 5/10 midsternal chest pain that she described as both a pressure type pain and a feeling of indigestion. When assessing this pain further, the patient said she has had this same pain constantly for the last week, but she had come to the ER yesterday due to the chest pain worsening to 8/10. When going through her chart, she had nitro spray ordered as a prn for chest pain as well as a daily lasix iv order. No one had given this patient nitro before, and this patients systolic bp was only 105. I asked another more experienced nurse what she would do, and she said she was a little worried about giving this patient nitro if she hadnt had any in the past, and her BP was a bit on the low side. I repeated her 12-lead ECG and I didnt see any changes from the other three. The patient also had three negative trops from when she first came in. so, my question is whether I should have tried giving Nitro to this patient or not? Is nitro meant for a more acute onset of chest pain as opposed to chest pain that has remained unchanged for the last week? I have read other things about nitro and how it is good for CHF because it helps to reduce the workload of the heart, but im not 100% sure what should have been done for this patient, and I cant stop thinking about it...please help!!!