A cardiologist names some likely causes for chest pain and jaw pressure in the middle of the night. 

The cause of pain in your chest or pressure in your jaw that awakens you in the middle of the night isn’t necessarily a heart attack.

“There are many possible causes,” says Dr. Sameer Sayeed, a cardiologist at ColumbiaDoctors of Somers, NY.

Angina As a Cause

“Cardiac causes can include coronary artery disease with rest angina, especially in those with lower heart rates at night,” says Dr. Sayeed.

Coronary artery disease means plaque buildup in the arteries. This so-called sludge reduces blood flow through the heart.

Angina is a condition in which clogged coronary arteries lead to this reduced blood flow in the cardiac muscle, causing chest pain and/or shortness of breath.

When this occurs only upon physical exertion, exercise or highly charged emotions such as during a heated argument, it’s called stable angina. Jaw pressure may occur.

When it occurs during rest, such as during sleep or napping, it is called unstable angina. Here too, pressure in the jaw may occur.

Leaky Heart Valve As a Cause

Another cause of chest pain overnight that’s accompanied by jaw pressure is leaky valves in the heart.

An echocardiogram will detect if this is the case. Leaky valves as well can decrease cardiac blood flow.

Inflammation As a Cause

“Another cause can be pericarditis and inflammation of the sac around the heart, and pericardial effusion or fluid around the heart, which can be worse with lying down and flat, and can wake people up at night with chest pain,” explains Dr. Sayeed.

“This kind of pain can also occur in the setting of pulmonary embolus or blood clot in the lung. But the most common cause would be coronary disease with low flow as above.”

Dr. Sayeed performs echocardiograms and stress tests at the Midtown Manhattan and Westchester offices at Columbia Doctors. He is also trained in cardiac CT imaging.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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