Why does the heart feel uncomfortable when lying down, requiring one to sit up?
Disease description:
A colleague's father feels discomfort in his heart, especially when lying down. Why does he experience heart discomfort when lying down and must sit up?
Doctor's answer (1)
Dr. Tian Hongbo
Feeling discomfort in the chest when lying down and needing to sit up may involve the following possible causes:
1. The most common cause is heart failure. When heart failure occurs, the heart's ability to pump blood decreases. Lying down increases venous return to the heart, which加重 the cardiac workload, leading to pulmonary congestion and difficulty breathing, known as "paroxysmal nocturnal dyspnea."
2. Pulmonary diseases such as pneumonia, pleural effusion, and pneumothorax may also cause similar symptoms.
3. Heart valve disease and coronary artery disease may also lead to similar symptoms. When sitting up, gravity reduces venous return, and the thoracic cavity expands, which helps improve respiratory and cardiac hemodynamic conditions, thereby relieving symptoms.
4. It could also be cardiovascular neurosis, which is usually related to psychological stress or emotional conditions. Treatment typically involves psychotherapy as the primary approach, with medication as an adjunct.
The above are only some possible causes; a diagnosis should not be made based on symptoms alone. If symptoms persist or worsen, timely medical consultation is recommended.
