Angina When Lying Down

Causes of chest pain

Does unpredictable chest pain wake you up? Or feel tightness in your chest when you are lying down? Oftentimes, the pain subsides with rest, but there are times when the pain can be sudden and unpredictable. If you experience that, you might have Angina Decubitus, which is caused by low oxygen supply to your heart. 

This article tries to clarify what you might be struggling with by informing you about what Angina Decubitus is, and what you can do to prevent and treat it. 

What is angina decubitus?

Angina is characterized by chest pain commonly experienced during exercise and stress. It occurs when there is restricted blood flow to the muscles of the heart, and thus lower oxygen levels in the heart. The blood supply to the heart can be reduced by narrowing coronary arteries, which supply your heart with blood. It can also be caused by thick heart muscles requiring more oxygen. In short, if the heart does not receive enough oxygen, patients experience chest pain.12 

There are two main kinds of Angina: 

  • Stable Angina 
  • Unstable Angina 

In stable angina, patients experience pain during exercise and stress, due to increased blood pressure. The chest pain in stable angina is relieved as one rests and often lasts around 20 minutes. There also is unstable angina, which is characterized by chest pain during exercise and rest so that it can occur at any time without warning. Angina is referred to as Angina Decubitus when the pain is experienced while lying down. It occurs when the blood flow to the arteries in the heart is constricted heavily, and the oxygen supply is too low for the heart muscles to function properly. This constriction could occur due to plaques and blood clots in the arteries.9, 12

Signs and symptoms

Symptoms of Angina Decubitus include:1, 11 

  • Sudden chest pain or tightness in the chest - during rest
  • Pain in the jaw, stomach, shoulder, or back
  • Shortness of breath
  • Tight feeling in the chest
  • Anxiety
  • Panic attack 
  • Fatigue

Usually, the pain should subside after a few minutes. If you experience the mentioned symptoms and they do not subside, reach out to health care professionals immediately. 

Causes and risk factors

chest pain occurs when the heart does not receive enough oxygen due to a suppressed blood flow due to plaques, which are fatty substances in the arteries that supply the heart with oxygen. This plaque build-up is also referred to as atherosclerosis. Moreover, blood clots on the plaque can further constrict the artery. This occurrence can be facilitated when the heart muscles are thicker, as a thicker muscle requires more oxygen.

Risk Factors include: 

  • High blood pressure 
  • high cholesterol levels
  • Obesity
  • Smoking
  • Being male 
  • Insufficient exercise
  • If you have people with heart diseases in your family, you are more likely to suffer from angina. 
  • Angina decubitus can lead to heart attacks when the arteries constrict too much. 

Diagnosis

Angina decubitus can be diagnosed using Electrocardiograms (ECGs), which measure the heart's rhythm. Angina can also be diagnosed using a computed tomography (CT) scan. To be diagnosed, you should see your doctor. 

Management and treatment

Treatment options include: 

  • Dietary adjustments
  • Medications 
  • Surgery

Angina can be treated using medication such as vasodilators, which increases the diameter of your arteries. Moreover, a healthy diet can help treat angina. In the diet, cholesterol and salt intake should be lowered. Furthermore, Angina Decubitus can be treated by the intake of blood thinners. In severe cases, Angina can be treated with surgery. Surgery may include methods such as inserting a small tube into your artery that keeps the space for the blood to run through. How to treat your angina should be discussed with your healthcare provider. 459, 11

Prevention

To prevent Angina decubitus, you can: 

  1. stay active 
  2. a healthy diet 
  3. lower salt intake 
  4. lose weight (if you are overweight) 
  5. lower stress levels 
  6. refrain from smoking

To stay active, you can go on walks regularly. To improve your diet, you could maintain a varied diet with low amounts of saturated fat. Eating less salt will also decrease your blood pressure, which is another way Angina can be prevented. Furthermore, stress can cause Angina. Therefore, managing stress levels can help prevent the illness as well, as stress increases blood pressure. There are many ways stress levels can be managed.1

Complications

Complications for angina decubitus include a high risk of heart attacks. If the pain does not subside, seek medical help immediately, as you might be having a heart attack. Furthermore, experiencing chest pain might lead to patients doing less exercise, which could further worsen the symptoms. Other complications include abnormal heart sounds and rhythm, which can be observed with an ECG, cardiac enlargement, which means that your heart increases in size, which decreases its efficiency, and high blood pressure.13

Outcome

While there is currently no cure for Angina Decubitus, patients can lead a good life while dealing with Angina Decubitus. Especially when recommended adjustments are made, many patients live a happy life with Angina Decubitus.  

When to see a doctor

If you experience chest pain, whether it is during rest or exercise/stress, even if the pain subsides after a few minutes of rest, reach out to your doctor. Call the emergency phone number if the pain does not stop or decrease over time. For further information, speak to your healthcare provider.

Summary

Angina Decubitus is a type of angina in which patients experience pain or tightness in their chest while lying down. It occurs because of reduced blood flow in the coronary arteries and the resulting low oxygen supply to the heart muscles. Symptoms include chest pain, fatigue, shortness of breath, and anxiety. High blood pressure, being overweight, and smoking are some of the risk factors.

To treat and manage angina, patients can make dietary and lifestyle adjustments that can greatly increase their quality of life. Angina can be diagnosed by your healthcare provider using different tools, such as ECGs. To prevent Angina, such lifestyle and dietary adjustments are recommended as well. Complications can be as severe as a heart attack, but might also include abnormal heart sounds, and an increased heart volume. 

If you experience any of the symptoms, reach out to your healthcare provider for advice. While there is currently no cure, with some lifestyle adjustments, patients with angina decubitus can lead a good and happy life. 

References:

  1. Angina - Causes, symptoms & treatments [Internet]. [cited 2022 Sep 30]. Available from: https://www.bhf.org.uk/informationsupport/conditions/angina
  2. Atherosclerosis - what is atherosclerosis? | nhlbi, nih [Internet]. [cited 2022 Sep 30]. Available from: https://www.nhlbi.nih.gov/health/atherosclerosis
  3. Blood thinners: types, side effects and drug interactions [Internet]. Drugwatch.com. [cited 2022 Sep 30]. Available from: https://www.drugwatch.com/health/cardiovascular-health/blood-thinners/
  4. Chen J, Chen Z, Xu Y, Gao R, Kuo W, Yao K, et al. Re-evaluation of the mechanism and treatment of angina decubitus. Chin Med Sci J. 1996 Mar 1;11(1):8–12.
  5. Chong CR, Ong GJ, Horowitz JD. Emerging drugs for the treatment of angina pectoris. Expert Opinion on Emerging Drugs [Internet]. 2016 Oct 1 [cited 2022 Sep 30];21(4):365–76. Available from: https://doi.org/10.1080/14728214.2016.1241231
  6. Computed tomography(Ct) [Internet]. [cited 2022 Sep 30]. Available from: https://www.nibib.nih.gov/science-education/science-topics/computed-tomography-ct
  7. Electrocardiogram(Ecg) [Internet]. nhs.uk. 2017 [cited 2022 Sep 30]. Available from: https://www.nhs.uk/conditions/electrocardiogram/
  8. Healthy diet [Internet]. [cited 2022 Sep 30]. Available from: https://www.who.int/news-room/fact-sheets/detail/healthy-diet
  9. LONGMIRE WP Jr, CANNON JA, KATTUS AA. The surgical treatment of angina pectoris. AMA Archives of Internal Medicine [Internet]. 1959 Dec 1 [cited 2022 Sep 30];104(6):886–92. Available from: https://doi.org/10.1001/archinte.1959.00270120042006
  10. Stress [Internet]. [cited 2022 Sep 30]. Available from: https://www.bhf.org.uk/informationsupport/risk-factors/stress
  11. Unstable angina: causes, symptoms and treatment [Internet]. Cleveland Clinic. [cited 2022 Sep 30]. Available from: https://my.clevelandclinic.org/health/diseases/21744-unstable-angina
  12. What are the different types of angina? [Internet]. Klarity. [cited 2022 Sep 30]. Available from: https://my.klarity.health/what-are-the-different-types-of-angina/
  13. WHITE PD, BLAND EF, MISKALL EW. The prognosis of angina pectoris: a long time follow-up of 497 cases, including a note on 75 additional cases of angina pectoris decubitus. Journal of the American Medical Association [Internet]. 1943 Nov 27 [cited 2022 Sep 30];123(13):801–4. Available from: https://doi.org/10.1001/jama.1943.02840480001001
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Magdalena Pfaff

Bachelor’s in liberal arts and Sciences – Neuroscience, University College Maastricht

Pursuing a Bachelor in the field of neuroscience with special interest in the connection of body and mind from a biological perspective. She is a motivated and ambitious student who has experience in working in the laboratory, as well as in a therapeutic environment. By combining mental and physical health, she wants to do research and work with patients.

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