How was cardiac ischemia confirmed in your case, i.e. what type of test(s) confirmed this condition?
I just finished two good doses of fast acting nitro (about 2 hours ago) and I feel much better. Not only has my chest pain decreased, but I feel much better overall. That's what nitroglycerin is supposed to do. My heart is receiving more blood, so it is pumping better and I have more energy. It also may have prevented another heart attack.
Angina, or chest pain due to a lack of blood flow to the heart muscle (cardiac ischemia, which is caused by coronary artery blockages, or coronary artery spasms), is different in many people. It is especially experienced differently in some women, compared to men. Mine is a very dull, burning ache that comes straight from the heart. The pain radiates from my heart and sometimes travels down my left arm. I also feel totally exhausted in the worst of ways. I have heart disease and over did work today in 95 degree temperature. Heart disease patients cannot stand weather extremes and I knew better but...
You need to monitor your BP since you have changed meds. The only reason to NOT take nitro is if you have extremely low BP, which doesn't seem to be your case. Nitro lowers the BP sometimes because it is a vasodilator. It causes your coronary arteries to get bigger (the rest of your arteries too). Always sit down before you take the nitro. If your BP is lowered suddenly, you could faint. It can give you a nasty headache for 5-15 minutes, when we take the small doses at home. Given in an iv at the hospital, it can give you a big headache!
So, you asked when to use it and I say whenever you suspect you need it. Women sometimes become nauseous and have vague pains in their left arm, neck or jaw, I have read. They can also experience angina as some men do. That is pain radiating from the heart. I have also had in in my back, directly behind my heart. This is not unusual, I have read.
It is not far from your heart to your mid chest region, so don't let that confuse you.
Stress will definitely cause angina!!!!! Anger can too. Fear started me off today. My wife was out doing whatever women do(?) today for about 4 hours. I was out back on the deck working (with my back to the door) and she opened the door and startled me. Is she thinking of my life insurance? Lol.
Don't worry about nitro damaging your heart. It won't, but it will save your life :)