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 is done by exclusion of other illnesses.
The most common type of angina is usually caused by a blockage in one or more coronary arteries. This causes a reduced blood supply to a part, or parts, of your heart muscle. The blockages are caused by atherosclerosis. In CSX angina is assciated with coronary arteries that appear to be normal.
- Older patients and women with Metabolic Syndrome are more likely to diagnosed with syndrome X than other patients.
- Common symptoms and findings include:
- Angina but with a normal echocardiogram.
- Abnormal stress test with changes similar to that of coronary artery disease, in contrast to Prinzmetal’s angina. Myocardial perfusion imaging can be abnormal in 30% of patients.
- Normal coronary angiogram.
- Other causes of chest pain must be ruled out, including:
- Syndrome X may be associated with other vasospastic disorders, such as migraine and Raynaud’s phenomenon.
It is treated with beta-blockers, and usually carries a favorable prognosis.