A person with chronic nitroglycerin exposure who has an interruption in that exposure may develop rebound symptoms on re-exposure.
Person affected: typically an industrial exposure
Clinical features:
(1) The person has sufficient nitroglycerin exposure to develop tolerance (asymptomatic despite significant exposure).
(2) There is interruption of nitroglycerin exposure for a few days, such over a weekend or holiday.
(3) On return to work the person has a re-exposure to nitroglycerin.
(4) After the re-exposure the person experiences the onset of vasodilatory symptoms (headache, tachycardia, dizziness, etc).
(5) With continued exposure the symptoms resolve.
Differential diagnosis:
(1) nitroglycerin withdrawal
(2) nitroglycerin dependence
