Final answer:
The management for a patient with unstable angina and refractory chest pain to nitroglycerin involves immediate and longer-term treatments, which may include medication, interventional procedures, or surgery.
Step-by-step explanation:
The management for a patient with unstable angina and refractory chest pain to nitroglycerin involves immediate treatment and longer-term treatments. Immediate treatments include administering supplemental oxygen, aspirin to break up clots, and nitroglycerin sublingually to improve blood flow. Longer-term treatments may involve injections of thrombolytic agents, such as streptokinase, to dissolve clots, the use of anticoagulant heparin, balloon angioplasty and stents to open blocked vessels, or bypass surgery. If the damage is extensive, coronary replacement with a donor heart or a coronary assist device may be considered.