[The dipyridamole echocardiography test combined with isometric loading in the diagnosis of syndrome "X"]

Syndrome "X" comprises a heterogeneous group of patients with normal coronarographic findings whose repeatedly occurring chest pain is of ischaemic origin, similarly as angina pectoris in patients with CHD. One of the signs of ischaemic etiology of pain in these patients is significant depression of the ST interval on the ECG during ergometry. We were interested to know whether the depression of the ST interval and angina pectoris which develop during a load are associated also with a transient disorder of left ventricular local kinetics. We examined therefore five patients, using the dipyridamol test combined with an isometric load evaluated by two-dimensional (2D) echocardiography. All examinations revealed a normal coronarographic finding and significant electrocardiographic manifestations of ischaemia during ECG stress test. The investigation showed that none of the patients with "X" syndrome suffered from transient changes in the local kinetics of the heart muscle and we assume therefore that myocardial ischaemia in syndrome "X" does not affect a sufficiently large portion of the cardiac wall in the transmural section to be manifested by impaired kinetics detectable by 2D-echocardiography.