How can chest pain be managed during the night?

Question

Hello doctor,

Six months ago, my father was hospitalized due to pleural effusion. After conducting all the tests, we discovered that he has cardiomyopathy, for which the doctor prescribed several medications. He is taking Atorvastatin with Clopidogrel, Nitroglycerin 2.6 mg, Perindopril erbumine with Indapamide, Bisoprolol, Metformin, and Glipizide. However, recently, almost every night, he has experienced burning and pain in both his chest and back while trying to sleep. We have done a chest X-ray, echocardiography, blood tests, and an ECG.

Please suggest what steps we should take next.

Answer 1

Hello,

Welcome to icliniq.com.

Did he undergo angiography at that time? Can you attach his test reports or a summary? First, you should consult his cardiologist again and have him checked for the cause of the pain. This pain may be related to a non-cardiac cause, such as musculoskeletal issues or gastric reflux. Does he also experience pain on exertion, or is it relieved with rest? If yes, it could be related to the heart. In that case, he will need angiography, and additional medications may be required.

There is no mention of antacid medication here, so you should discuss starting antacids like Pantoprazole and Domperidone, taken once daily before breakfast. He should avoid oily, spicy foods and heavy meals, especially at night. It is important to visit the cardiologist, get him examined, and possibly adjust his medications, particularly by adding antacids. You should also discuss the need for angiography and adding cardiac medications.

I hope this helps you.

Thank you.