Editor's Choice-Chest pain relief in patients with acute myocardial infarction

Eur Heart J Acute Cardiovasc Care. 2016 Jun;5(3):277-81. doi: 10.1177/2048872615584078. Epub 2015 Apr 22.


Chest pain is the prevalent symptom at presentation in patients with acute myocardial infarction (AMI). Despite the complete absence of rigorous studies designed to assess the impact of morphine administration in patients with AMI, clinical practice guidelines strongly recommend morphine for analgesia. However, when using morphine to relieve chest pain in AMI patients, physicians must be aware that hypotension, respiratory depression, vomiting, and delayed onset of action of antiplatelet agents are potential unwanted side effects of the drug. The purpose of this report is to review morphine's clinical and side effects and to propose strategies able to reduce chest pain in AMI patients.

Keywords: STEMI; antiplatelets; chest pain; morphine; myocardial infarction; prasugrel; ticagrelor.

Publication types

  • Review

MeSH terms

  • Analgesics / administration & dosage*
  • Analgesics / therapeutic use
  • Chest Pain / drug therapy*
  • Humans
  • Myocardial Infarction / complications*
  • Pain Management
  • Practice Guidelines as Topic


  • Analgesics