Cardiac syndrome X: Current concepts

Singh, Mukesh; Singh, Sarabjeet; Arora, Rohit; Khosla, Sandeep

doi:10.1016/j.ijcard.2009.11.021

Cited by 44 publications

(49 citation statements)

References 108 publications

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“…first showed an association between chest pain and electrocardiogram (ECG) changes with changes in microcirculation [12]. Although there is a discussion of whether CSX should be treated as a form of ischemic heart disease, some studies have reported that patients with CSX account for about 10-20% of all patients with symptoms of angina and it was seen that more than 50% of these patients had a persistence of chest pain not responding to short-acting nitrates after exercise [13][14][15]. Because of the exclusion of MAfrom other classic forms of ischemic main coronary vessels, no standard treatment approach exists.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

Elbo�a¹

2017

Ann Clin Anal Med

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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.

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Section: Discussionmentioning

confidence: 99%

Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

Elbo�a¹

2017

Ann Clin Anal Med

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“…In order to explain Gamze Babur Güler et al, Factor XIII Val34Leu polymorphism in patients with cardiac syndrome X the pathophysiological abnormality, various theories such as abnormal coronary flow reserve [8], insulin resistance [9], enhanced red cell sodium--hydrogen exchange [10], and abnormal cardiac sensitivity [11] were suggested. The most proven and accepted ideas are endothelial dysfunction and inflammation, and increased sensitivity to pain [3,12]. Endothelial dysfunction reduces the release of anti-inflammatory and anti-thrombogenic factors and reduces the availability of nitric oxide by disrupting the vasoconstriction/vasodilatation balance [13].…”

Section: Discussionmentioning

confidence: 99%

“…Studies showed that the prognosis of CSX, which is considered in the class of stable angina pectoris, was generally better than the prognosis of the patients with acute coronary syndrome and patients detected to have a disorder in coronary angiography [1,2]. Myocardial ischemia due to coronary microvascular dysfunction and increased sensitivity to pain are the mechanisms predominantly considered to be responsible for the pathophysiological process, while reasons such as insulin resistance, estrogen deficiency, and autonomous dysfunction are also being discussed for etiology [3].…”

Section: Introductionmentioning

confidence: 99%

Factor XIII Val34Leu polymorphism in patients with Cardiac Syndrome X

et al. 2013

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“…It is possible that the syndrome may result from a combination of coronary microvascular dysfunction and increased sensitivity to painful stimuli. 3 There is no uniform definition for diagnosing CSX in the literature. 4 Diagnosis of CSX requires the exclusion of epicardial abnormalities by coronary angiography (CAG).…”

Section: Introductionmentioning

confidence: 99%

Clinical profile of patients with cardiac syndrome X in a tertiary care hospital

2017

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Background: Abnormalities in coronary microcirculation may lead to symptoms of chest pain which mimics angina. Symptoms of chest pain along with evidence of ischemia on non-invasive tests like electrocardiography (ECG), echocardiography or treadmill test (TMT) but with normal coronary angiogram (CAG) is referred to as cardiac syndrome X (CSX). Previous studies have shown favourable prognosis in such patients. However recent studies have not shown good prognosis. We intend to understand whether such adverse cardiovascular outcomes could be secondary to any change in the clinical characteristics of patients with CSX in the current era.Methods: This is a retrospective study which was conducted at a tertiary care hospital. CAG of patients who underwent coronary angiography between November 2013 and October 2016, for suspected ischemic heart disease was reviewed. Clinical characteristics of patients with normal or non-obstructive coronaries (less than 50% stenosis) in angiography with chest pain were analyzed. Further clinical characteristics, ECG, echocardiography, treadmill test and CAG findings were compared among males and females.Results: 410 patients were included in the study. 212 were females and 198 were males. Mean age of presentation was 53.46±10.5 years for males and 55.04±9.3 years for females. Patients presenting with atypical chest pain were higher (70.7%). There were 195 subjects with systemic hypertension, 103 with diabetes mellitus and 57 had dyslipidemia. In the study, most 260 subjects had ST-T changes on ECG. Abnormal echocardiography was seen in only 35 patients. 30.5% patients showed positive stress test for inducible ischemia.Conclusions: CSX is prevalent in significant number of patients who present with symptoms of chest pain. Unlike previous studies, there is no significant difference among males and females, in prevalence and risk factors for this syndrome. Further non-obstructive lesions were found to be higher in females.

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Cardiac syndrome X: Current concepts

Cited by 44 publications

References 108 publications

Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

Factor XIII Val34Leu polymorphism in patients with Cardiac Syndrome X

Clinical profile of patients with cardiac syndrome X in a tertiary care hospital

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