Why does my husband get chest pains when he lies down?

A man suffering chest pain

My husband has angina and takes medications for this. Although his spray does help, he has to sleep in a chair as he gets chest pains when he lies down. Why can’t he lie down?

Dr Mike Knapton says:

This is a distressing but not uncommon situation. The pain could be due to angina, which is usually related to coronary heart disease, where arteries supplying the heart muscle with blood are narrowed (due to atheroma). If the blood flow is insufficient, it can cause a cramp-like pain due to the heart muscle not receiving enough oxygen to do its job.

This is a distressing but not uncommon situation

Other common causes of these symptoms are acid reflux and heart failure. Acid reflux happens when stomach acid leaks up into the oesophagus, or gullet, causing pain and difficulty swallowing. This is more likely to occur when your husband is lying down and gravity is not working in his favour.

Heart failure is a condition where the heart muscle is weakened, meaning it doesn’t pump blood around the body as well as it used to. When you lie down, the redistribution of blood in the body causes the symptoms to get worse, and this is usually experienced as shortness of breath.

Your husband must therefore establish if the pain is due to angina or some other problem, as this will determine which treatment is likely to work for him. I would suggest he sees his GP or heart specialist for a review of his condition.

Read our feature on how to get the most out of your GP

Mike KnaptonMeet the expert

Dr Mike Knapton is Associate Medical Director (Prevention and Care) at the BHF, overseeing the strategic role in helping patients and the public reduce their risk of heart disease. He remains a GP and works one day a week at a practice in Cambridge.

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