A Review of Adverse Outcomes Following Intravenous Morphine Usage for Pain Relief in Acute Coronary Syndrome

Chest pain in acute coronary syndrome (ACS) unresponsive to nitrates is routinely treated by intravenous (IV) morphine. In the past two decades, several studies have emerged, suggesting poorer outcomes in patients receiving this treatment; however, morphine remains the drug of choice for these patients as per the American College of Cardiology/American Heart Association guidelines on ACS management. The results of various studies that examined the impact of morphine on myocardial infarct size, antiplatelet therapy absorption time, and patient mortality are discussed. There is mounting evidence suggesting that morphine may increase adverse events in ACS patients, therefore, the development of more precise criteria for IV morphine administration in ACS patients is needed.