Cardiac Syndrome X
Cardiac syndrome X (CSX) is anginal chest pain with coronary artery disease involving the smallest arteries, but with normal large coronary arteries. Because of this, it is sometimes referred to as “microvascular angina”. Syndrome X is difficult to diagnose; usually it . Patients with cardiac syndrome X (typical chest pain and normal coronary arteriograms) represent a heterogeneous syndrome, which encompasses different pathogenic mechanisms. Although symptoms in most patients with cardiac syndrome X are non-cardiac, a sizable proportion of them have angina pectoris due to transient myocardial ctcwd.com by:
Patients with cardiac syndrome X typical chest pain and normal coronary arteriograms represent what is dividend policy decision heterogeneous s, which encompasses different pathogenic mechanisms.
Although symptoms in most patients with cardiac syndrome X are non-cardiac, a sizable proportion of them have angina pectoris due to transient myocardial ischemia. Thus radionuclide myocardial perfusion defects, coronary sinus oxygen saturation abnormalities and pH changes, myocardial lactate production and stress-induced alterations of cardiac high energy phosphate suggest an ischemic origin of symptoms in at least a proportion of patients ayndrome cardiac syndrome X.
Microvascular abnormalities, caused by endothelial dysfunction, appear to be responsible for myocardial ischemia in patients with cardiac syndrome X. Endothelial dysfunction is likely to be multifactorial in these patients and it is conceivable that risk factors such as hypertension, hypercholesterolemia, diabetes mellitus and smoking can contribute to its development.
Most patients with cardiac syndrome X are postmenopausal women and estrogen deficiency has been syndgome proposed as a pathogenic factor in female patients. Additional factors such as abnormal pain perception may contribute to the pathogenesis of chest pain in patients with angina pectoris and normal coronary angiograms.
Although prognosis is good regarding survival, patients with cardiac syndrome X have an impaired quality of life. Management of this syndrome represents a major challenge to the treating physician.
Understanding the mechanism underlying the condition is of vital importance for patient management. Thus diagnostic tests should aim at identifying the cause of the symptoms in the individual patient, i.
Moreover, it is important to bear in mind that treatment of cardiac syndrome X should be mainly directed towards improving quality of life, as prognosis is usually good in these patients. Conventional antianginal agents such nitrates, calcium channel antagonists, beta-adrenoceptor antagonists and nicorandil are effective particularly in patients in whom chest pain and ECG changes are clearly suggestive of myocardial ischemia and in those with objective documentation of ischemia.
Angiotensin-converting enzyme inhibitors have been cardiaac to be useful in syndrome X patients with increased adrenergic tone, borderline systemic hypertension, and those with documented endothelial dysfunction.
Analgesic interventions of different sorts have been proposed based on the hypothesis that somatic and visceral perception of pain is altered in cardiac syndrome X patients. Pharmacological agents such as imipramine and aminophylline, and neural electrical stimulation techniques have been assessed in recent years with encouraging results.
Psychological treatment, particularly cognitive therapy, appears to syndroms useful in defined patient subsets. Relaxation techniques such as transcendental meditation have been successfully used in small studies and shown to improve not only chest pain but also exercise-induced ST segment changes. Reports indicate that these techniques improve quality of life. Abstract Patients with cardiac syndrome X typical chest pain and normal coronary arteriograms represent a heterogeneous syndrome, which encompasses different pathogenic mechanisms.
Publication types Research Support, Non-U. Gov't Review.
Apr 01, · Cardiac syndrome X (CSX) is thought to be a type of angina. In CSX you feel chest pain when your heart works harder but the heart arteries appear to be normal on coronary ctcwd.com: Dr Colin Tidy. Apr 28, · A patient is said to have Cardiac Syndrome X if he is suffering from chest pain associated with angina, even though there isn’t any blockage in the coronary arteries. Patients who’ve had angina describes the condition as a squeezing or suffocating sensation inside their chest. Dec 24, · Cardiac syndrome X (CSX) is typical anginalike chest pain with evidence of myocardial ischemia in the absence of ?ow-limiting stenosis on coronary angiography. Cannon et al termed this entity.
This is unlike a heart-attack and the heart muscle is not damaged interminably, while the pain subsides upon resting. Angina attacks occur due to coronary artery disease CAD , when the heart needs extra oxygen-rich blood as in the case of exercising. Patients suffering from cardiac syndrome X exibhit the pain associated with angina but they do not have CAD, i. No specific cause is known for Syndrome X. Usually a myriad risk factors exist that act together leading to the condition.
The lack of blood flow caused by a microvascular disease and the enhanced pain perception can be two factors of the syndrome. Risk factors include abdominal obesity which is a result of excessive fat tissue in and around the abdomen. Another reason might be atherogenic dyslipidemia, a blood fat disorder, and elevated blood pressure. Additional risk factors include insulin resistance or glucose intolerance and prothrombic state or proinflammatory state.
A nuclear stress test exercise radioisotopic test is done where a radioactive substance is injected into the bloodstream. The flow through the arteries is examined by the doctor to determine if your heart muscle is damaged. By performing coronary angiography, a dye is introduced into the bloodstream via an injection to give the doctor an x-ray movie of the heart action as the blood flows through it.
It should be noted that in patients with CAD, this test shows the blocked artery but in the case of syndrome X, the results are completely normal.
So, if the doctor obtains an abnormal exercise stress test and a normal coronary angiogram then the patient is considered to have syndrome X. Nitrates are used as medication to stop the chest pain.
Nitroglycerin widens the blocked arteries to improve blood flow. Alternative to nitrates include calcium channel blockers or beta blockers that reduce the chest pain by relaxing muscle cells found on the lining of the artery thus improving blood flow while lowing blood pressure.
Oxygen demand of the heart is also reduced by these medicines. Aminophylline as well as estrogen works in the case of women. Consulting your physician and bringing about lifestyle changes also contribute to tackling and preventing the occurence of this syndrome. Patients are recommended to follow a healthy diet low in saturated fats coupled with regular physical activities. You may have to try a variety of these treatments before figuring out which is the most optimum for you.
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It is mandatory to procure user consent prior to running these cookies on your website. What is Cardiac Syndrome X? Heart Diseases April 28, June 4, By admin 0 comments 0 likes. Causes of Cardiac Syndrome X Risk factors include abdominal obesity which is a result of excessive fat tissue in and around the abdomen.
Treatment of Syndrome X Nitrates are used as medication to stop the chest pain. Leave a Reply Cancel Reply Your email address will not be published.
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