Angina, AMI, and NTG

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I am getting ready to take EMT-b for the coming summer term and I've been studying hard for about two months reading various texts, including the DOTNSC and the American Academy of Orthopaedic Surgeon's Emergency Care and Transportation of the Sick and Injured. The first EMS prepatory text I read was the Kaplan EMT-Basic Exam, and in the pharmacology section of that text there exists the following passage:

"If the chest pain is alleviated with NTG, then the physican may suspect that the cause of the chest pain is not myocardial infarction, but a spasm in the coronary arteries called angina pectoris

Am I to take this as meaning that if the patient is experiencing anginal symptoms that are alleviated by sublingual NTG, then there is not worry of the patient suffering a heart attack during this event?
 
In short, no. The patient may be experiencing ischemic pain, relieved by NTG, but may also be actively infracting. So, just because the NTG reduces or alleviates pain there is no way a basic can, or should ever, "rule out" any additional cardiac components.
 
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Great, thank you. I hadn't seen anything like that in any of the other texts. I just noticed though, that it reads " The PHYSICIAN MAY SUSPECT, which seems supplimentary and misleading in this context.
 
This is an old concept, but unfortunately, it goes both ways. Pain that's relieved by nitro does support it being ischemic in nature, but by how the definitions work, if it's relieved by nitro it generally falls into a different category along the spectrum of Acute Coronary Syndromes -- stable angina rather than anything higher-grade (unstable angina, NSTEMI, or STEMI). A total or near-total occlusion of a coronary artery probably won't be relieved by the effects of nitro -- that's like trying to unblock a stopped sink by turning down the tap a bit.

With that said, neither side is certain. Totally non-ischemic causes of CP can be relieved by nitro in odd cases (even acid reflux, for instance), and a 100% STEMI can see some relief. So I wouldn't put much weight on it.
 
The answer is no.

Pain that is relieved by GTN can not be assumed to be angina.
 
This is great, thank you all for your responses, I have a much better understanding of this concept now.
 
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