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Dr. Andrew Rynne

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What causes sudden chest pain while waking up from the sleep?

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Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 1632 Questions

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Posted on Sat, 13 Oct 2018 in General Health
Question: I had chest pain last night which woke me from my sleep. I had no other symptoms. No acid, no weakness or dizziness, no tingling or pain. The episode lasted about 10-15 minutes. I got up and walked around the house, drank some water and raised my arms above my head. I had difficulty swallowing. Raising my arms eased the pain temporarily. I was unable to burp, but I did pass some gas. I have had this kind of pain in the past, with similar results. Since this has occurred twice in the last week, I thought I would ask. My doctor checked my heart and lungs a couple of months ago and liked what he heard.Which is the most likely cause of these symptoms?
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Answered by Dr. Antoneta Zotaj 33 minutes later
Brief Answer:

There are several causes of chest pain but heart issues should be ruled out first.

Detailed Answer:
Hello,

The chest pain has many causes and 3 most likely in your case are:

1. GERD (gastroesophageal reflux disease)- meaning acid reflux in your throat might cause some burning locally and the patient might feel it as a chest pain. It s generally worse at night due to the acid reflux more likely to happen at night.

2. Muscular-sceletal pain which is due to the chest wall and generally is effected by movements and breathing.

3. A heart problem or the so called Ischemia. Due to you being a male and due to your age and pain at night that is less than 15 minutes and wakes you up at night it is always advisable to have a check with your doctor to rule out a heart Ischemia which is a very important diagnosis and should be ruled out first in your case.

I understand your doctor already heard your lungs and heart but generally Ischemia is not diagnosed with auscultation (hearing the heart).
It is important to have some tests like ECG, heart ultrasound and heart enzymes blood tests as a first step.

The doctor might also ask for a chest X-ray and also other few more tests. As a general check in these cases the doctor might do what we call the metabolic panel which contains sugar level check in blood, kidney function (Creatinine and electrolytes), CBC, liver tests (ALT, AST), urinalysis, etc.


To conclude I would say that:

1. Due to importance of heart problems in your age group and gender it is important to rule out heart as the cause of your symptoms with Ischemia the most important one.

2. Several tests and examinations are needed to have this diagnosis ruled out or ruled in as the case is


Hope I have answered your query.
Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Antoneta Zotaj 1 hour later
Since you mentioned "sugar level" I should have said that I have been diagnosed with type II diabetes, although it is under control and my last A1C was 6.5. Does this alter your response?
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Answered by Dr. Antoneta Zotaj 9 hours later
Brief Answer:
You seem to have good control of diabetes but, still the heart issues should be ruled out.

Detailed Answer:
Hello,

I mention sugar level because patients with diabetes have a higher risk for cardiovascular problems. Your HbA1c seems to be very good level so it seems you have it well under control.

Still the heart issues have to be ruled out though so i would say you will need to talk to your doctor and have the above tests done to make sure your heart is well.

Hope I have answered your query.
Let me know if I can assist you further.

Kind regards,
Antoneta Zotaj, MD
Above answer was peer-reviewed by : Dr. Kampana
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