Wake up with discomfort in heart region but after 1hr vigorous exercise feel fine. i take atenolol, lisinopril, flecainide for mild arrhythmia. worry?

Not likely: This is unlikely a cardiac problem if you are not experiencing chest discomfort during vigorous exercise.

Generally, whenever: We hear chest pain, there is concern. Though generally chest pain increases with exertion, unstable angina can cause pain at any time. You may try something for reflux, like zantac (ranitidine) prior to bed, but consider a baby asa and follow up with your doc. Good luck.