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 (509 Responses)
  1. trailer parts and repair near me


    May 13, 2021 at 08:38 | Report abuse | Reply
  2. camper remodel supplies


    May 13, 2021 at 08:57 | Report abuse | Reply
  3. Chevy Van Repair Panels


    May 13, 2021 at 09:39 | Report abuse | Reply
  4. bucket truck repair near me


    May 13, 2021 at 10:10 | Report abuse | Reply
  5. boom truck repair

    I absolutely love your website.. Pleasant colors & theme. Did you make this site yourself? Please reply back as I’m trying to create my very own website and want to find out where you got this from or just what the theme is called. Cheers!


    May 13, 2021 at 10:50 | Report abuse | Reply
  6. 2800 Suspension Repair Sprinter Van

    When I initially left a comment I appear to have clicked the -Notify me when new comments are added- checkbox and now whenever a comment is added I recieve four emails with the same comment. There has to be a means you are able to remove me from that service? Thank you!


    May 13, 2021 at 11:46 | Report abuse | Reply
  7. rv parts and repair

    I could not resist commenting. Exceptionally well written!


    May 13, 2021 at 13:42 | Report abuse | Reply
  8. wall paint shops near me


    May 13, 2021 at 19:11 | Report abuse | Reply
  9. rv furniture california


    May 13, 2021 at 21:52 | Report abuse | Reply
  10. Authorized Sprinter Repair Shop


    May 14, 2021 at 00:04 | Report abuse | Reply
  11. horse trailers in california

    This excellent website definitely has all the information and facts I wanted concerning this subject and didn’t know who to ask.


    May 14, 2021 at 01:30 | Report abuse | Reply
  12. RV Beds Orange County

    Aw, this was an extremely nice post. Taking the time and actual effort to make a superb article… but what can I say… I hesitate a lot and never manage to get anything done.


    May 14, 2021 at 03:25 | Report abuse | Reply
  13. Mercedes Sprinter Van 2015 3500 Repair

    That is a really good tip especially to those fresh to the blogosphere. Simple but very accurate information… Thank you for sharing this one. A must read post!


    May 14, 2021 at 05:25 | Report abuse | Reply
  14. camper trailer repair near me

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


    May 14, 2021 at 06:33 | Report abuse | Reply
  15. movies stores near me


    May 14, 2021 at 08:36 | Report abuse | Reply
  16. Mercedes Benz Sprinter Service Center Near Me

    Very good info. Lucky me I discovered your website by accident (stumbleupon). I have bookmarked it for later!


    May 14, 2021 at 13:44 | Report abuse | Reply
  17. Maserati Granturismo Lease Specials

    Spot on with this write-up, I absolutely believe this web site needs a lot more attention. I’ll probably be returning to read through more, thanks for the advice!


    May 14, 2021 at 15:35 | Report abuse | Reply
  18. house for sale spirit lake idaho


    May 14, 2021 at 17:12 | Report abuse | Reply
  19. realtor wallace


    May 14, 2021 at 17:55 | Report abuse | Reply
  20. Maserati Limo


    May 14, 2021 at 19:51 | Report abuse | Reply
  21. box truck door repair near me

    This blog was... how do you say it? Relevant!! Finally I've found something that helped me. Appreciate it!


    May 14, 2021 at 23:41 | Report abuse | Reply
  22. Vsp Providers For Glasses


    May 15, 2021 at 07:35 | Report abuse | Reply
  23. property for sale hauser id

    There is definately a great deal to learn about this subject. I like all of the points you have made.


    May 15, 2021 at 07:43 | Report abuse | Reply
  24. oc collision


    May 15, 2021 at 08:27 | Report abuse | Reply
  25. Lasik Eye Surgery Phoenix

    Everything is very open with a very clear explanation of the challenges. It was definitely informative. Your site is very helpful. Thank you for sharing!


    May 15, 2021 at 11:02 | Report abuse | Reply
  26. three bedroom homes for sale near me

    Your style is so unique compared to other people I have read stuff from. Many thanks for posting when you've got the opportunity, Guess I'll just book mark this site.


    May 15, 2021 at 13:25 | Report abuse | Reply
  27. Seo Marketing Experts

    I blog frequently and I seriously thank you for your information. This article has really peaked my interest. I will take a note of your website and keep checking for new information about once per week. I subscribed to your Feed as well.


    May 15, 2021 at 17:14 | Report abuse | Reply
  28. Social Media Marketing Events

    Good post. I learn something new and challenging on sites I stumbleupon every day. It's always helpful to read articles from other authors and use something from other sites.


    May 15, 2021 at 18:42 | Report abuse | Reply
  29. Internet Marketing Experts


    May 15, 2021 at 22:24 | Report abuse | Reply
  30. Digital Marketing Orange County


    May 15, 2021 at 22:59 | Report abuse | Reply
  31. aika online private server download

    Pretty! This has been an extremely wonderful article. Many thanks for supplying this info.


    May 16, 2021 at 00:13 | Report abuse | Reply
  32. Frightliner Sprinter Repair Shop


    May 16, 2021 at 14:06 | Report abuse | Reply
  33. 2017 Maserati Quattroporte S Q4 Granlusso


    May 16, 2021 at 14:28 | Report abuse | Reply
  34. 2019 Maserati Quattroporte Gts Gransport


    May 16, 2021 at 15:26 | Report abuse | Reply
  35. Sprinter Side Door Repair

    Oh my goodness! Amazing article dude! Thank you so much, However I am encountering issues with your RSS. I don’t understand the reason why I cannot subscribe to it. Is there anyone else getting the same RSS issues? Anybody who knows the solution will you kindly respond? Thanx!!


    May 16, 2021 at 15:53 | Report abuse | Reply
  36. Mercedes Benz Sprinter Repair Shop

    This is a very good tip particularly to those new to the blogosphere. Brief but very precise information… Many thanks for sharing this one. A must read post!


    May 16, 2021 at 16:45 | Report abuse | Reply
  37. Mercedes Sprinter Brake Caliper Repair Kit

    It’s hard to find knowledgeable people in this particular subject, however, you seem like you know what you’re talking about! Thanks


    May 16, 2021 at 22:17 | Report abuse | Reply
  38. Van Rust Repair


    May 16, 2021 at 22:33 | Report abuse | Reply
  39. Wheelchair Van Repair Near Me

    Hi, I do believe this is an excellent site. I stumbledupon it 😉 I may come back yet again since I book-marked it. Money and freedom is the best way to change, may you be rich and continue to help others.


    May 16, 2021 at 22:44 | Report abuse | Reply
  40. 2006 Mercedes Sprinter 2500 Turbo Actuator Repair

    The very next time I read a blog, I hope that it won't disappoint me just as much as this one. After all, Yes, it was my choice to read through, however I actually believed you would probably have something useful to talk about. All I hear is a bunch of complaining about something that you could fix if you weren't too busy seeking attention.


    May 16, 2021 at 23:52 | Report abuse | Reply
  41. Sprinter Repair Shop

    Everyone loves it when people come together and share ideas. Great website, stick with it!


    May 17, 2021 at 02:53 | Report abuse | Reply
  42. Van Meter Auto Repair


    May 17, 2021 at 05:08 | Report abuse | Reply
  43. Mercedes Sprinter Service Center Near Me


    May 17, 2021 at 06:33 | Report abuse | Reply
  44. Maserati Granturismo Gt


    May 17, 2021 at 09:46 | Report abuse | Reply
  45. Maserati Quattroporte For Sale


    May 17, 2021 at 10:10 | Report abuse | Reply
  46. Egr Def Repair Mercedes Sprinter


    May 17, 2021 at 12:04 | Report abuse | Reply
  47. bucket truck services

    I love it when folks get together and share opinions. Great blog, continue the good work!


    May 17, 2021 at 14:15 | Report abuse | Reply
  48. rv state inspection near me

    I like it when folks get together and share ideas. Great website, keep it up!


    May 17, 2021 at 16:01 | Report abuse | Reply
  49. RV Driver Seats California

    Good article. I absolutely love this site. Thanks!


    May 17, 2021 at 16:55 | Report abuse | Reply
  50. Maserati Ye

    Very good article. I will be dealing with a few of these issues as well..


    May 17, 2021 at 18:47 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11

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.