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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes difficulty in breathing when I lie down?

Answered by
Dr. Meriton Siqeca


Practicing since :2009

Answered : 773 Questions

Posted on Wed, 7 Dec 2016 in Hypertension and Heart Disease
Question: I have been diagnosed with an enlarged heart, the hospital and there on staff cardiologist, ran me through a good 24 hrs of testing, I have great insurance. I had trouble breathing one night, felt like someone was sitting on my chest, no pain, no heart attack, just difficult to breath. They came with the diagnosis, recommended that I again, contact, my sleep aptena doctor, he waited 3 months after I did the sleep-over test, but I feel that my weight, still has a lot to do with it. I am about 290, large frame, always been athletic, have high blood pressure, my family doctor, I asked, I would be a good candidate for Gastropoda bypass or stomach stapling surgery, after a specific 6 month diet, I'm retired/disabled from work, I was a field mechanic on heavy construction equipment, I've had 5 spinal surgeries, all fusions C5,C6,C7 and L4,L5,S1, last surgery in February 2010, what do you think ? Thank you
Answered by Dr. Meriton Siqeca 4 hours later
Brief Answer:
All the conditions combined, producing symptoms

Detailed Answer:
Hello and welcome to HCM. I understand your concerns. Thank you for your questions.

Well, indeed sleep apnoea and obesity may cause you to have difficulty breathing when lying down, but it is more proeminent while you are asleep, which causes snoring and the "choking" episodes during sleep. However, in this case, I think that the enlarged heart (dilated cardiomyopathy) has played a great role.

During dilated cardiomyopathy, the heart has the insufficiency to throw the destinated amount to the periphery, thus keeps more blood in it, in comparison with people with a normal heart. This containment of blood means pressure to the "upper floors" of the heart, which means the lungs. This pressure to the lungs is especially reflected when one is going from standing position to lying down and it is reflected as a sudden difficulty to catch a breath, which is relieved when one sits up - paroxysmal nocturnal dyspnea.

In this regard, I would recommend you to consult your cardiologist about adding a diuretic (furosemide and/or spironolactone) to your therapy, which relieves pressures to the heart and lungs, also discontinue the beta-blocker that you may be on, since this is a class of drugs that constricts the bronchi.

Also, in the end, suction bronchodilator pumps should be prescribed to ameliorate the sleep apnea, or, after a consult with a pulmonologist, continues oxygen therapy throughout the night.

I hope my insight helps. I am happy to help, if you have any follow-up questions.

Kind regards,
Dr. Meriton
Above answer was peer-reviewed by : Dr. Arnab Banerjee

The User accepted the expert's answer

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