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cardiac syndrome X
Epidemiology:
- women
Pathology:
- decreased blood flow to heart tissue
- normal coronary arteries
Clinical manifestations:
- angina pectoris
- chest pain on exertion
Special laboratory:
- electrocardiogram
- baseline lateral ST segment depression may be present
- exercise stress test
- ST segment changes suggestive of myocardial ischemia
- myocardial perfusion testing abnormal in ~30% of patients
- coronary angiography is normal
- echocardiogram is normal
Differential diagnosis:
- Prinzmetal's angina
- Takotsubo cardiomyopathy
- chest pain on exertion not typical of Takotsubo cardiomyopathy
- ST segment elevation
- echocardiogram shows apical ballooning
- antecedent stressor
Management:
- beta blocker
- prognosis is generally good
General
angina pectoris
References
- Wikipedia: Cardiac syndrome X
http://en.wikipedia.org/wiki/Cardiac_syndrome_X
- Devabhaktuni SR and Lange RA
eMedicine: Cardiac Syndrome X
http://emedicine.medscape.com/article/1967073-overview
- Medical Knowledge Self Assessment Program (MKSAP) 18,
American College of Physicians, Philadelphia 2018
- Loffler AI, Bourque JM.
Coronary Microvascular Dysfunction, Microvascular Angina, and Management.
Curr Cardiol Rep. 2016 Jan;18(1):1. Review.
PMID: 26694723 Free PMC Article
- Patient.co.uk: Cardiac syndrome X
http://www.patient.co.uk/health/cardiac-syndrome-x-leaflet