Subsequent to NSTEMI heart attack 20 weeks ago with elevated troponin but no CA blockages found in two cath studies (nothing meriting PCI/stenting), I was placed on low-dosages of Lopressor, Norvasc , ASA, clopidigrel(Plavix) and simvastatin with Nitrostat 0.4mg PRN for chest pain. The cardiologist has discontinued the Plavix and the Ca-channel blocker (originally prescribed by another cardiologist one week after my first admission on the suspicion that the recurring chest pain may be vasospastic in origin, i.e. Prinzmetal s. The pain is never related to exertion, rather it occurs during the night awakening me or occasionally just before hour of sleep or shortly after awakening (unstable angina?) To rule out the possibility that we were chasing the wrong thing, my cardiologist prescribed a course of omeprazole (PPI) and when pain recurred shifted to trial of ranitidine ( histamine H2 antagonist ). Recurring chest pain, often associated with numbness in left hand and/or pain in left arm, is always relieved within one to three minutes following use of Nitro. If, in fact, these episodes are gastroesophageal in origin rather than cardio, would you expect the Nitro to be so consistently effective? I lie flat on my back with legs elevated after administering Nitro and this does not interfere with effectiveness in resolving the pain.