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.

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