What causes chest tightness and a blocked feeling when lying flat at night?

Lying flat at night and experiencing chest tightness or blockage may be caused by pleurisy, heart failure, coronary atherosclerotic heart disease, and other conditions. Treatment should be based on the underlying cause.

1. Pleurisy

Pleurisy can lead to inflammatory exudate, which accumulates along the lower edge of the pleural cavity and exerts pressure on lung tissue, causing a sensation of chest tightness or blockage when lying down at night. Under medical guidance, treatment may include medications such as cefuroxime tablets, cefixime tablets, or ofloxacin tablets.

2. Heart Failure

Patients with heart failure often feel chest tightness, which improves when sitting up. Symptoms may also include shortness of breath, dyspnea, and breathlessness, all of which worsen with physical activity. Diagnosis can be confirmed via echocardiography or BNP testing. Under medical supervision, treatment may involve medications such as furosemide tablets, hydrochlorothiazide tablets, or spironolactone tablets.

3. Coronary Atherosclerotic Heart Disease

This includes conditions such as myocardial ischemia and exertional angina. Emotional stress or physical overexertion can increase the heart's oxygen demand, while narrowed coronary arteries reduce blood flow, leading to myocardial ischemia and hypoxia. This may manifest as chest tightness or discomfort when lying flat at night. Under medical guidance, patients may take myocardial-nutrient medications such as levocarnitine tablets or trimetazidine tablets, and should ensure adequate rest.

In addition, chest tightness when lying flat at night could also result from intercostal neuralgia, which requires active treatment. Patients are advised to maintain healthy lifestyle habits, engage in appropriate exercise, and strengthen their immune system.