October 27th, 2010
02:22 PM ET

Is my chest pain related to heart disease?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesday, it's Dr. Otis Brawley, a chief medical officer for the American Cancer Society.

Question asked by Kent Curran of Lehigh Acres, Florida

I was diagnosed with dilated cardiomyopathy about four years ago. Recently I noticed that when I am lying down flat on my back I experience chest pain/tightness and difficulty breathing. Is this related to my heart disease?

Expert answer:

Dear Kent,

Of course you should be talking frankly with your doctor as this can be very serious. You would benefit from seeing a cardiologist.

A cardiomyopathy is when the heart muscle is weakened. There are at least five types of cardiomyopathy. In the type known as "dilated cardiomyopathy," the heart is larger than normal and the muscular walls are usually thicker than normal.

All cardiomyopathies can lead to congestive heart failure, which is when the heart is unable to pump an adequate supply of blood throughout the body. The thickening of the heart muscle seen in dilated cardiomyopathy can also lead to rhythm disturbances which are abnormalities of the heart beat. Both heart failure and rhythm disturbances can be quite serious.

Perhaps the most common reason for chest pain, tightness in the chest and difficulty breathing specifically when lying down is gastroesophageal reflux disease which I discussed last week.

These symptoms occur when the act of lying flat causes acidic gastric contents to move up into the esophagus and burn it. It is a mistake for any patient to assume that the symptoms of chest pain, tightness in the chest and difficulty breathing are caused by GERD. Very importantly these symptoms can be caused by congestive heart failure, certain diseases of the heart valves, and diseases of the great vessels such as an aortic aneurysm.

The textbook example of congestive heart failure is a patient who has shortness of breath when lying flat that is relieved by sitting up. Anyone with the symptoms described needs to be accurately diagnosed and treated aggressively by a skilled physician.

The evaluation for GERD is one of several nuclear medicine or radiologic tests. It is also common to do an endoscopy. In this test a flexible fiberoptic scope is passed through the mouth in order to look for inflammation of the esophagus and stomach. Even if there is evidence of GERD, the physician may choose to do a cardiac work-up as both can occur in the same patient.

The heart is commonly evaluated with a series of electrocardiograms, an echocardiogram, and anuclear medicine tests of the heart. An echocardiogram is a sophisticated ultrasound of the heart.

A patient may also be a candidate for a cardiac catheterization to measure the pressures in the heart and assess the status of the arteries of the heart (coronary arteries). Treatment of CHF usually involves medications to lower blood pressure and decrease the amount of fluid the heart needs to pump.

Aneurysms or out pouching of blood vessels are less likely the cause of the symptoms. They are usually seen with echocardiogram or through radiologic imaging. They often need to be corrected with a vascular surgery but can sometimes be treated though minimally invasive catheterization.

« Previous entry
soundoff (580 Responses)
  1. RV Repair Orange County California

    The next time I read a blog, Hopefully it won't disappoint me just as much as this one. After all, I know it was my choice to read through, but I really believed you would probably have something interesting to talk about. All I hear is a bunch of whining about something you can fix if you weren't too busy searching for attention.


    June 19, 2021 at 23:15 | Report abuse | Reply
  2. Content Marketing Experts


    June 20, 2021 at 02:05 | Report abuse | Reply
  3. Social Media Marketing Companies


    June 20, 2021 at 03:56 | Report abuse | Reply
  4. Local Marketing Agencies

    Great post! We are linking to this great content on our site. Keep up the good writing.


    June 20, 2021 at 06:17 | Report abuse | Reply
  5. Digital Marketing Near Me

    I absolutely love your site.. Excellent colors & theme. Did you make this website yourself? Please reply back as Iím looking to create my own site and would like to find out where you got this from or just what the theme is named. Kudos!


    June 20, 2021 at 09:13 | Report abuse | Reply
  6. Glady Lossius

    When I initially left a comment I appear to have clicked the -Notify me when new comments are added- checkbox and now each time a comment is added I receive four emails with the exact same comment. Perhaps there is a means you can remove me from that service? Kudos!


    June 20, 2021 at 12:33 | Report abuse | Reply
  7. Stevie Fitgerald


    June 20, 2021 at 14:04 | Report abuse | Reply
  8. Emmaline Chilen

    Good post. I learn something totally new and challenging on sites I stumbleupon everyday. It will always be useful to read content from other authors and use a little something from other web sites.


    June 20, 2021 at 14:25 | Report abuse | Reply
  9. Shanda Sembler


    June 20, 2021 at 14:44 | Report abuse | Reply
  10. Julissa Koehne

    Greetings! Very helpful advice within this article! It is the little changes that make the biggest changes. Many thanks for sharing!


    June 20, 2021 at 18:00 | Report abuse | Reply
  11. Wilma Granthan

    I needed to thank you for this very good read!! I definitely loved every little bit of it. I have you saved as a favorite to look at new stuff you postÖ


    June 20, 2021 at 18:01 | Report abuse | Reply
  12. Lakesha Mccullers

    Pretty! This was a really wonderful article. Many thanks for supplying these details.


    June 20, 2021 at 21:29 | Report abuse | Reply
  13. 7 eleven near me


    June 20, 2021 at 23:24 | Report abuse | Reply
  14. Sprinter Repair Shop Near Me


    June 21, 2021 at 00:30 | Report abuse | Reply
  15. RV Repair Fountain Valley


    June 21, 2021 at 01:11 | Report abuse | Reply
  16. big lots near me

    When I initially left a comment I appear to have clicked on the -Notify me when new comments are added- checkbox and from now on every time a comment is added I receive four emails with the exact same comment. Is there an easy method you are able to remove me from that service? Cheers!


    June 21, 2021 at 01:16 | Report abuse | Reply
  17. RV Repair Shops Nearby

    That is a very good tip especially to those fresh to the blogosphere. Brief but very precise informationÖ Appreciate your sharing this one. A must read article!


    June 21, 2021 at 04:27 | Report abuse | Reply
  18. gastroenterologist near me

    Right here is the perfect website for everyone who really wants to understand this topic. You understand a whole lot its almost tough to argue with you (not that I actually will need toÖHaHa). You certainly put a brand new spin on a topic that has been discussed for decades. Great stuff, just excellent!


    June 21, 2021 at 04:51 | Report abuse | Reply
  19. RV Repair Garden Grove


    June 21, 2021 at 07:54 | Report abuse | Reply
  20. house for rent near me


    June 21, 2021 at 11:30 | Report abuse | Reply
  21. Sprinter Van Paint Shop Near Me

    Right here is the right webpage for anybody who hopes to find out about this topic. You realize a whole lot its almost tough to argue with you (not that I really will need toÖHaHa). You certainly put a new spin on a subject which has been written about for ages. Excellent stuff, just wonderful!


    June 21, 2021 at 14:52 | Report abuse | Reply
  22. RV Repair Shop Near Me

    Oh my goodness! Amazing article dude! Thanks, However I am encountering issues with your RSS. I donít understand the reason why I cannot join it. Is there anybody getting identical RSS issues? Anyone who knows the solution will you kindly respond? Thanks!!


    June 21, 2021 at 16:16 | Report abuse | Reply
  23. Body Damage Shop

    I really like reading through an article that can make men and women think. Also, many thanks for allowing me to comment!


    June 21, 2021 at 16:39 | Report abuse | Reply
  24. RV Repairs Near My Location

    Aw, this was a really good post. Taking the time and actual effort to generate a very good articleÖ but what can I sayÖ I hesitate a lot and never seem to get nearly anything done.


    June 21, 2021 at 16:54 | Report abuse | Reply
  25. Mercedes Sprinter Body Repair


    June 21, 2021 at 19:47 | Report abuse | Reply
  26. Camper Repairs Near Me

    Iím impressed, I have to admit. Seldom do I come across a blog thatís both educative and amusing, and let me tell you, you've hit the nail on the head. The issue is something which too few people are speaking intelligently about. Now i'm very happy that I stumbled across this during my hunt for something concerning this.


    June 21, 2021 at 20:05 | Report abuse | Reply
  27. Sprinter Repair Costa Mesa


    June 21, 2021 at 23:36 | Report abuse | Reply
  28. Sprinter Service Repair

    Saved as a favorite, I really like your blog!


    June 22, 2021 at 03:11 | Report abuse | Reply
  29. RV Repair Shops Nearby

    That is a good tip particularly to those new to the blogosphere. Short but very precise informationÖ Appreciate your sharing this one. A must read post!


    June 22, 2021 at 05:22 | Report abuse | Reply
  30. RV Trailer Repair Near Me


    June 22, 2021 at 06:02 | Report abuse | Reply
  31. RV Engine Repair Near Me


    June 22, 2021 at 06:23 | Report abuse | Reply
  32. Camper Van Repair Shop Near Me


    June 22, 2021 at 11:05 | Report abuse | Reply
  33. Sprinter Van Repair


    June 22, 2021 at 12:36 | Report abuse | Reply
  34. Emergency RV Repair Near Me


    June 22, 2021 at 17:00 | Report abuse | Reply
  35. Van Maintenance Shop Near Me

    Great info. Lucky me I came across your website by chance (stumbleupon). I have saved it for later!


    June 22, 2021 at 17:14 | Report abuse | Reply
  36. RV Chassis Repair Near Me

    Greetings, I do think your blog might be having browser compatibility problems. When I look at your website in Safari, it looks fine however, if opening in IE, it has some overlapping issues. I just wanted to provide you with a quick heads up! Aside from that, wonderful blog!


    June 22, 2021 at 17:38 | Report abuse | Reply
  37. Social Media Marketing Consultants Near Me

    You need to be a part of a contest for one of the best sites on the internet. I most certainly will highly recommend this blog!


    June 22, 2021 at 18:15 | Report abuse | Reply
  38. ron burgundy podcast


    June 22, 2021 at 18:27 | Report abuse | Reply
  39. Social Media Marketing Agency

    Excellent post. I will be experiencing some of these issues as well..


    June 22, 2021 at 20:02 | Report abuse | Reply
  40. SEO Marketing Firms

    Iím amazed, I must say. Rarely do I come across a blog thatís both equally educative and amusing, and without a doubt, you've hit the nail on the head. The problem is something that not enough men and women are speaking intelligently about. I'm very happy I found this in my hunt for something concerning this.


    June 22, 2021 at 23:01 | Report abuse | Reply
  41. Local Marketing Consultants

    This web site truly has all of the information I wanted about this subject and didnít know who to ask.


    June 22, 2021 at 23:03 | Report abuse | Reply
  42. Video Marketing Companies

    Right here is the perfect web site for anyone who would like to find out about this topic. You understand so much its almost hard to argue with you (not that I actually will need toÖHaHa). You certainly put a brand new spin on a subject that has been written about for decades. Wonderful stuff, just wonderful!


    June 23, 2021 at 00:19 | Report abuse | Reply
  43. RV And Truck Repair Near Me

    This is a topic that's close to my heart... Many thanks! Exactly where are your contact details though?


    June 23, 2021 at 01:06 | Report abuse | Reply
  44. RV Body Repair Shops Near Me


    June 23, 2021 at 01:48 | Report abuse | Reply
  45. Google Marketing Agency


    June 23, 2021 at 04:06 | Report abuse | Reply
  46. RV Repair Service Near Me


    June 23, 2021 at 04:11 | Report abuse | Reply
  47. RV Repair Services Near Me


    June 23, 2021 at 07:12 | Report abuse | Reply
  48. reveal podcast


    June 23, 2021 at 07:59 | Report abuse | Reply
  49. RV Water Repair Man Near Me


    June 23, 2021 at 08:55 | Report abuse | Reply
  50. RV Service Repair Near Me

    Good post. I learn something new and challenging on websites I stumbleupon every day. It will always be interesting to read articles from other authors and use a little something from other websites.


    June 23, 2021 at 12:01 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12

Post a comment


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

« Previous entry
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.