were compared and found consistent in 51 (63%) patients. A coronary narrowing < 50% was detected by coronary angiogram in 4 (5%) of the remaining patients. Coronary angiogram was found to be normal in the remaining 26 patients (32%) and these patients were evaluated as cardiac syndrome X (CSX) known as microvascular angina (MA). Discussion: The findings showed that MPS is superior to coronary angiogram in the early diagnosis of myocardial perfusion disorders at the microvascular level. Therefore, we concluded that MPS should be the primary diagnostic tool to begin treatment before an anatomically large narrowing occurs in the coronaries.