Reviews in CADAnalgesia in acute ischemic chest painYan, Wenjiang; Yang, Shaozhong; Chen, Liang; Yang, JingjingAuthor Information Key Laboratory of Cardiovascular Remodeling and Function Research, Shandong University Qilu Hospital, Chinese Ministry of Education, Chinese Ministry of Health and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China Received 22 September 2019 Accepted 25 February 2020 Correspondence to Jingjing Yang, MD, PhD, Shandong University Qilu Hospital, 107 Wenhua Xi Ave, Jinan, Shanodng Province, Jinan, Shandong, China, Tel: +086 13793133312; fax: +86 531 8616 9356; e-mail: firstname.lastname@example.org Coronary Artery Disease: September 2020 - Volume 31 - Issue 6 - p 556-564 doi: 10.1097/MCA.0000000000000887 Buy Metrics Abstract Analgesics, particularly opioids, have been routinely used in the emergency treatment of ischemic chest pain for a long time. In the past two decades; however, several studies have raised the possibility of the harmful effects of opioid administration. In 2014, the American Heart Association (AHA)/American College of Cardiology Foundation (ACCF) changed the guidelines regarding the use of opioids from class IC to class IIb for non-ST elevation acute coronary syndrome. And in 2015, the European Society of Cardiology (ESC) guidelines incidentally noted the side effects of opioids. In ST-segment elevation myocardial infarction, both ESC and AHA/ACCF still recommend the use of opioids. Given the need for adequate pain relief in ischemic chest pain in the emergency setting, it is necessary to understand the adverse effects of analgesia, while still providing sufficiently potent options for analgesia. The primary purpose of this review is to quantify the effects of analgesics commonly used in the prehospital and emergency department in patients with ischemic chest pain. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.