jen,

Thanks for your question. 

There are two issues here and they may very well be related to each other.  The first is your chest pain, the cause of which is still unknown.  Nitroglycerin (NTG) spray can relieve chest pain that is caused by your heart as well as few other causes (esophageal spasm for one) but I am concerned with treating a symptom without knowing the cause.  The major possibility for concern here is your heart.  You need to be evaluated by your physician who will take your history by asking you several detailed questions, followed by an examination and an electrocardiogram.  Then he/she will be in a good position to determine whether your heart is a possible cause.  If necessary, this may be followed by further testing.

The second issue is your elevated blood pressure.  Yes, Nitroglycerin will bring this down, but this is not the ideal method of treating this problem.  Is your pressure related to your chest pain?  This is a distinct possibility which make the above evaluation even more important.  Chest pain, and other pain, can certainly cause a rise in blood pressure.  And high blood pressure can, in some cases, cause chest pain, especially if there is an underlying heart problem. 

Your doctor will take both of these issues into consideration and try to get to the bottom of things.  Using NTG spray as needed is not the optimal therapy without knowing the cause.  It can quickly lower blood pressure in some people and cause severe headaches in many people.  It is best used by people with chest pain caused by coronary artery disease, and in an emergency room setting, can be used to lower pressure quickly. 

You need a longer term solution to your problem, which means you need to know what the problem(s) is.  So make an appointment with your doctor as soon as possible.

I'm sorry, but I am not familiar with the term grade 1 left ventricular.

Best wishes and feel better.

Martin Cane, M.D.