Angina and position

 Q: Angina pectoris tends to get worse with lying down?

A) True

B) False

Answer: A

There is conventional teaching that angina is constant pain or discomfort which does not change with change in breathing or position. In actuality, angina may get worse with lying down. In the supine position, there is an increase in venous return causing an increase in myocardial wall stress.

Other factors to worsen angina include increase physical activity, cold, emotional trauma, sexual intercourse, large meals, use of cocaine or other recreational drugs.

#cardiology

References:

Kloner RA, Chaitman B. Angina and Its Management. J Cardiovasc Pharmacol Ther. 2017 May;22(3):199-209. doi: 10.1177/1074248416679733. Epub 2016 Dec 14. PMID: 28196437. 

 Constant J. The diagnosis of nonanginal chest pain. Keio J Med. 1990 Sep;39(3):187-92. doi: 10.2302/kjm.39.187. PMID: 2255129.