My mother's chest pain increases while sleeping. Is there any problem or just gastric pain?

Question

Hi doctor,

My mother is having chest pain. And the pain increases while sleeping. I have attached her ECG report. Could you please tell is there any problem or it is because of gastritis? Thanks.

Answer 1

Hello,

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Her ECG (electrocardiogram) is normal (attachments removed to protect the patient’s identity). Based on her symptoms, it is unlikely to be a cardiac pain. Cardiac pain or cardiac heaviness typically occurs on exertion and relieves with rest. Sometimes one can have breathlessness on exertion instead of chest pain. Pain that worsens on lying down is usually related to gastric reflux. I suggest her take an antacid like capsule Cyra-D (Rabeprazole and Domperidone) once daily before breakfast for five days. If there is a response, it is related to gastric reflux. She should avoid oily, spicy meals, have light meals, and walk after meals rather than rest immediately. Now, suppose she has symptoms after exertion, a family history of heart disease, or other risk factors. In that case, it is advisable to do an ECHO (echocardiogram), and if ECHO is normal, do a TMT (treadmill test) to rule out the cause for the pain. As ECG may not show any abnormalities in the early stages, it is recommended to do an ECHO and TMT as a screening investigation. I hope this helps you. Thanks.