You should not rule out a heart problem if you keep awakening with chest pain that gets better soon afterwards.
It may seem odd that a heart problem would cause chest pain only in the morning, but this is no reason to shrug off this symptom.
Another reason why you’re trying to convince yourself that this is nothing to worry about — is because if this were indeed a heart problem … why would it be occurring only when your body is at its lowest energy needs?
And then you get up for the day, increasing your body’s energy demands (it takes more energy, for instance, to walk around, wash up, make breakfast).
Yet the chest pain that was with you upon awakening has gone away.
This scenario does not fit the classic formula for a heart problem involving clogged arteries or even an arrhythmia.
The classic situation is that chest pain occurs upon physical exertion (or intense emotions), then subsides when the exertion ceases.
This is called stable angina. Blood flow to the heart is compromised due to blockages in the coronary arteries, but the situation is stable.
The patient is not considered to be in any immediate danger.
However, with unstable angina, chest pain occurs at rest (as well as with exertion—even the slightest).
People with unstable angina have actually been awakened by chest pain.
They have severe blockages that need urgent treatment. They can have a heart attack at any time.
But Here’s the Thing…
With unstable angina, there are also, invariably, episodes of chest pain throughout the day. Some days may be skipped, but the chest pain eventually returns while one is awake and about.
It can come at any time: morning, afternoon, evening, late at night while watching a movie – you name it, any time, including in the middle of the night when getting up to use the toilet.
But what’s up with chest pain ONLY in the morning as you awaken, and especially that it goes away soon after?
“These kinds of symptoms are called ‘atypical’ because they don’t necessarily occur when the heart’s oxygen demand is high,” says Dr. Kavitha Chinnaiyan, MD, a cardiologist at William Beaumont Hospital in Royal Oak, MI.
Dr. Chinnaiyan is founder of Heal Your Heart, Free Your Soul, an online, yoga-based prevention program.
“Unfortunately, there is no good way to tell just by symptoms if it is heart-related or not,” explains Dr. Chinnaiyan.
“If one has risk factors for heart disease (diabetes, high blood pressure, high cholesterol, high stress and smoking, for instance), it is better to assume that it may be cardiac and get checked.
“Anyone who has chest symptoms and has these risk factors must get it checked.
“Even when one is exceptionally physically fit, it is wise to get checked, particularly if the symptoms get worse or don’t go away.”
Non-Heart Causes of Chest Pain in the Morning
• Acid reflux (GERD). Stomach acid makes its way to your chest while you’re horizontal. Getting up causes gravity to send the acid back into the stomach.
• Anxiety. It’s time to get up and face the day and already your body’s having a stress response.+
• Asthma (but you likely will have already been diagnosed with this).
• CPAP use (an overnight air-flow device for people with sleep apnea; chest muscles may be sore due to exhaling against the air pressure).
• Costochondritis. Rib cage cartilage is sore (usually from exercise).
• Rib fracture
• Strained muscle from previous day’s gym workout
• Tietze syndrome—swollen or inflamed rib cartilage; not the same as costochondritis.
There are tons more possible causes of chest pain (e.g., pneumonia, bronchitis, esophageal spasm, blood clot in a lung).
But these other causes, as well as some of the ones listed above, will almost always cause chest pain at varying times throughout the day, not just only in the morning.