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Angina and normal coronary arteries in women: gynecologic findings
P M Sarrel1, D Lindsay, G M Rosano
1Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06510.
Objectives:
Our aim was to evaluate the hypotheses that women with severe angina and normal coronary arteries (syndrome X) have an increased incidence of hysterectomy and show a positive cardiac response to 17 beta-estradiol replacement therapy.
Study Design:
The gynecologic histories of 30 women with syndrome X were determined. Anginal and 17 beta-estradiol insufficiency symptoms were recorded daily for 1 month. Subsequently, 20 of the women underwent hyperemic response testing before and after 2 months of estrogen replacement therapy. Hyperemic response results were compared with those of 12 asymptomatic post-menopausal women not receiving estrogen replacement therapy. Symptoms were recorded daily during estrogen replacement therapy.
Results:
A total of 18 women (60%) underwent hysterectomy. All were experiencing hot flushes. Hyperemic response was diminished in women with syndrome X compared with controls. Hyperemic response increased and anginal symptoms decreased during estrogen replacement therapy.
Conclusion:
The incidence of hysterectomy was increased and estrogen replacement therapy alleviated cardiac symptoms and enhanced hyperemic response in a group of women with syndrome X.