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Cardiac syndrome X.

J T S Soares-Costa, J J B Soares Costa Teresa

    Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
    |December 28, 2006
    PubMed
    Summary

    Angina pectoris can occur without obstructive coronary artery disease, including in cardiac syndrome X (CSX). CSX is characterized by chest pain, positive exercise tests, and normal coronary angiography, with a good prognosis but no standard treatment.

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    Prinzmetal's variant angina.

    Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology·2005
    See all related articles

    Area of Science:

    • Cardiology
    • Internal Medicine
    • Clinical Research

    Background:

    • Angina pectoris typically results from atherosclerotic obstructive lesions in coronary arteries.
    • However, angina can also manifest in the absence of significant obstructive disease, presenting diagnostic challenges.
    • Cardiac Syndrome X (CSX) is a condition characterized by angina with normal coronary angiograms.

    Purpose of the Study:

    • To explore conditions causing angina pectoris without obstructive atherosclerotic lesions.
    • To define Cardiac Syndrome X (CSX) and its diagnostic criteria.
    • To review the pathophysiology, prognosis, and therapeutic approaches for CSX.

    Main Methods:

    • Review of literature on non-atherosclerotic causes of angina.
    • Analysis of diagnostic criteria for true CSX, including Bertrand et al.'s definition.
    • Discussion of proposed pathogenic mechanisms, focusing on microvascular dysfunction.
    • Evaluation of survival data and current therapeutic strategies.

    Main Results:

    • Angina can arise from non-atherosclerotic coronary obstructions or normal coronary angiography (CSX).
    • True CSX is defined by anginal pain, positive exercise tests, evidence of ischemia, and normal coronary angiography.
    • Pathogenesis likely involves microvascular dysfunction.
    • CSX is associated with an excellent survival prognosis.

    Conclusions:

    • Angina pectoris can occur in the absence of obstructive coronary atherosclerosis, with CSX being a key example.
    • While CSX has a favorable prognosis, its underlying mechanisms, primarily microvascular, require further understanding.
    • There is a lack of standardized therapeutic protocols for managing CSX, highlighting a need for further research and clinical guidelines.

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