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Syndrome X: a discussion of angina and normal coronary arteries
1Department of Cardiology, University of Pittsburgh Medical Center, PA 15213, USA.
Insights
Syndrome X, characterized by chest pain and heart attack despite normal arteries, involves impaired coronary microvascular function. This case highlights the condition's pathophysiology, diagnosis, and management.
Area of Science:
- Cardiology
- Vascular Biology
- Internal Medicine
Background:
- Syndrome X, also known as microvascular angina, presents with symptoms of coronary artery disease but lacks obstructive coronary artery disease.
- It is increasingly recognized as a distinct clinical entity affecting coronary microvascular function.
Observation:
- A female patient presented with typical angina and non-Q wave myocardial infarction.
- Coronary angiography revealed normal coronary arteries, ruling out significant epicardial stenosis.
Findings:
- The patient's condition was attributed to Syndrome X, involving impaired endothelial function of the coronary microvasculature.
- This leads to inappropriate vasoconstriction and reduced coronary flow reserve.
Implications:
- Understanding the pathophysiology of Syndrome X is crucial for accurate diagnosis and effective treatment.
- This case underscores the importance of considering microvascular dysfunction in patients with anginal symptoms and normal coronary arteries.
Abstract:
Syndrome X was diagnosed in a female patient who presented with typical angina and a non-Q wave myocardial infarction, yet demonstrated normal coronary arteries. Syndrome X has been described as an impairment in normal endothelial function of the coronary microvasculature, resulting in inappropriate vasoconstriction and inadequate coronary flow reserve. In this article we review pathophysiology, diagnosis, treatment, and prognosis in a single case.