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Syndrome X.

Al Suwaidi J¹, Lerman

¹Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. lerman.amir@mayo.edu

Current Treatment Options in Cardiovascular Medicine

|November 30, 2000

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Syndrome X, characterized by angina with normal coronary angiograms, involves complex coronary flow issues. Accurate diagnosis via vascular reactivity testing guides tailored treatments, including medications like calcium channel blockers and lifestyle changes.

Area of Science:

Cardiology
Vascular Medicine

Background:

Syndrome X presents as typical angina with normal coronary angiograms, indicating a complex pathophysiologic state.
Potential causes include altered pain perception and abnormal coronary flow reserve, affecting myocardial ischemia.

Purpose of the Study:

To emphasize accurate diagnosis through comprehensive coronary vascular reactivity evaluation.
To outline a management strategy for Syndrome X patients based on diagnostic findings.

Main Methods:

Diagnosis involves functional angiograms assessing endothelial-dependent and -independent coronary flow reserve.
Treatment strategies are tailored based on the presence or absence of coronary flow reserve abnormalities.

Main Results:

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Patients without flow reserve abnormalities may benefit from reassurance.

Abnormalities guide therapy, including avoiding spasm-inducing drugs, risk factor management, and medications like calcium channel blockers, nitrates, ACE inhibitors, and l-arginine.

Conclusions:

Accurate diagnosis of coronary vascular reactivity is crucial for Syndrome X management.
Treatment is individualized due to varying patient responses and the absence of a gold standard therapy.