Cardiac syndrome X

When Cardiac syndrome X patients suffering from angina pectoris, ECG shows changes consistent with ischemia, but ask yourself the coronary arteries in coronary angiography normal dar. patients have a good prognosis: neither the mortality nor the risk of cardiovascular events is increased; However, the quality of life is impaired.

Causes

Various physiological mechanisms are discussed that may lead to the syndrome X; probably lie the syndrome several underlying causes:

In particular, a dysfunction of the endothelium of the microvasculature is discussed. Accordingly, the vessels in the heart muscle that are not representable in the angiography, constricts blood plasma levels due to an increased endothelin. Since approximately 70 % of patients are women in menopause, estrogen deficiency probably also plays a role. Furthermore, it is described in many patients an increased sensitivity to pain.

Diagnostics

After a positive exercise ECG and a negative angiography myocardial perfusion can be studied under stress in the myocardial scintigraphy or MRI. The guiding principle in addition, the determination of coronary flow reserve and the study of endothelial function using the flow mediated dilation of the brachial artery.

Therapy

• Beta- blockers or calcium antagonists to reduce chest pain.
• In order to improve endothelial function, hormone replacement therapy, as well as reducing the risk factors for coronary heart disease.