What treatment should be administered first for a patient with respiratory distress of cardiac origin?

Oxygen therapy is a common first step in the management of respiratory distress; however, in cases where the distress stems from a cardiac origin, administering nitroglycerin is critical due to its vasodilatory properties. Nitroglycerin helps to relieve the workload on the heart by dilating the coronary arteries, which can improve blood flow and reduce myocardial oxygen demand. This is particularly important in cardiac distress scenarios, such as congestive heart failure or acute coronary syndrome, where the heart's ability to pump blood effectively is compromised.

By addressing the underlying cardiac issue with nitroglycerin, the treatment not only alleviates the respiratory distress but also contributes to a more stable cardiovascular status for the patient. In contrast, while oxygen therapy is essential and may be given concurrently, it does not address the primary problem of cardiac function directly. Other interventions like intubation or CPR would typically be reserved for more advanced airway management or life-threatening situations, which may not be immediately indicated in the setting of cardiac-related respiratory distress unless there is a clear progression toward respiratory failure.