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Syndrome X

A H Henderson1

  • 1Department of Cardiology, University of Wales College of Medicine, Cardiff, UK.

Cardiovascular Drugs and Therapy
|June 1, 1989
PubMed

Insights

Chest pain with normal coronary arteries often has non-cardiac origins. However, a small percentage may experience myocardial ischemia due to reduced coronary dilator capacity, a condition known as Syndrome X.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Anginalike chest pain with normal coronary arteriography is a frequent clinical presentation.
  • Approximately 20% of patients undergoing coronary arteriography report such symptoms.

Purpose of the Study:

  • To review the problem of anginalike chest pain in patients with normal coronary arteriographic findings.
  • To differentiate between noncardiac causes and potential myocardial ischemia.

Main Methods:

  • Review of clinical presentations of chest pain.
  • Analysis of coronary arteriographic findings.
  • Differential diagnosis including noncardiac and cardiac etiologies.

Main Results:

  • The majority of cases (ca. 20%) are attributed to noncardiac causes like thoracic root or esophageal pain.
  • A small subset of patients (ca. 0.1%) may have myocardial ischemia due to reduced coronary dilator capacity.
  • This ischemia, termed Syndrome X, has an unknown pathogenesis.

Conclusions:

  • While noncardiac causes are most common for chest pain with normal coronary arteries, Syndrome X remains a possibility.
  • Further investigation is needed for the pathogenesis of myocardial ischemia in Syndrome X.

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