Nocturnal angina pectoris
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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 early of sleep (likely due to increased venous return) or during the early morning hours (likely as a result of an increase in vascular tone).
Nocturnal Angina Pectoris
In clinical practice, two types of nocturnal angina are observed.
- Some patients experience angina within an hour or two after sleeping.
- The mechanism of angina in this group of patients is likely to be an increase in venous return and hence increased intra cardiac volume with a resulting increase in myocardial oxygen requirements.
- Other group of patients with nocturnal angina experience chest discomfort much later, in the early hours of the morning.
- In this group of patients, a primary reduction in coronary blood flow owing to increased coronary vascular tone, more likely related to different stages of sleep, has been postulated as the potential underlying mechanism.