Nocturnal angina pectoris: Difference between revisions
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==Overview== | ==Overview== | ||
Nocturnal angina is the occurrence of anginal discomfort either during the | Nocturnal angina is the occurrence of anginal discomfort either during the first hours of sleep or during the early morning hours. It is speculated that discomfort caused during the first hours of sleep is due to increased venous return, whereas the discomfort caused during the early morning hours is due to increased vascular tone. | ||
==Pathophysiology== | ==Pathophysiology== | ||
Revision as of 19:48, 14 May 2012
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Chronic stable angina Microchapters | ||
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Classification | ||
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Differentiating Chronic Stable Angina from Acute Coronary Syndromes | ||
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Diagnosis | ||
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Alternative Therapies for Refractory Angina | ||
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Discharge Care | ||
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Guidelines for Asymptomatic Patients | ||
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Case Studies | ||
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Nocturnal angina pectoris On the Web | ||
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Risk calculators and risk factors for Nocturnal angina pectoris | ||
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Nocturnal angina is the occurrence of anginal discomfort either during the first hours of sleep or during the early morning hours. It is speculated that discomfort caused during the first hours of sleep is due to increased venous return, whereas the discomfort caused during the early morning hours is due to increased vascular tone.
Pathophysiology
- Among patients who develop nocturnal angina within an hour or two of going to sleep, the mechanism of angina in this group of patients is likely to be an increase in venous return and hence increased intracardiac volume with a resulting increase in myocardial oxygen requirements.
- Among patients who develop nocturnal angina in the early morning hours a primary reduction in coronary blood flow resulting from increased coronary vascular tone has been postulated as the potential underlying mechanism. It is further asserted that this particular form of nocturnal angina is related to the biological changes associated with different stages of the sleep cycle.
Diagnosis
Symptoms
Two patterns of nocturnal angina are observed:
- Some patients experience angina within an hour or two after sleeping.
- Other group of patients with nocturnal angina experience chest discomfort much later, in the early hours of the morning.
Treatment
- The treatment is the same as chronic stable angina.
- If increased coronary vascular tone is felt to be the underlying mechanism, the calcium channel blockade may be of benefit.