Nocturnal angina pectoris: Difference between revisions

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==Overview==
==Overview==
Nocturnal angina is the occurrence of anginal discomfort either during the early hours of sleep or during the early morning hours. It is speculated that onset during the early hours of sleep results in an increased venous return causing in discomfort whereas onset during the early morning hours results in an increased vascular tone causing discomfort.
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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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:

  1. Some patients experience angina within an hour or two after sleeping.
  2. Other group of patients with nocturnal angina experience chest discomfort much later, in the early hours of the morning.

Treatment

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