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Abnormal cardiac pain perception in syndrome X
A Chauhan1, P A Mullins, S I Thuraisingham
1Regional Cardiac Unit, Papworth Hospital, Cambridge, England, United Kingdom.
Journal of the American College of Cardiology
|August 1, 1994
Summary
Patients with syndrome X experience chest pain due to an abnormal cardiac pain perception, not altered coronary blood flow. This study highlights a diminished pain threshold as a key factor in syndrome X chest pain.
Area of Science:
- Cardiology
- Pain Perception Research
- Gastroenterology
Background:
- Syndrome X, also known as cardiac syndrome X, is characterized by chest pain despite normal coronary arteries.
- Previous reports suggest altered pain perception in patients with syndrome X.
Purpose of the Study:
- To investigate if a reduced cardiac pain threshold contributes to chest pain in patients diagnosed with syndrome X.
- To differentiate the role of pain perception versus coronary blood flow abnormalities in syndrome X.
Main Methods:
- Intracardiac catheter manipulation was performed on four patient groups, including syndrome X, mitral valve disease patients, and heart transplant recipients.
- Coronary flow velocity and coronary flow reserve in response to papaverine were measured in syndrome X patients and heart transplant recipients.
Main Results:
- Intracardiac stimulation induced typical anginal chest pain in 94% of syndrome X patients.
- Chest pain was significantly less frequent in control groups (mitral valve disease and heart transplant recipients).
- Coronary flow reserve was significantly lower in the syndrome X group, but coronary blood flow velocity did not change with chest pain.
Conclusions:
- Abnormal cardiac pain perception is a fundamental characteristic of syndrome X.
- The findings suggest that a diminished pain threshold, rather than altered coronary hemodynamics, is central to chest pain in syndrome X.