Cardiac syndrome X

Cardiac syndrome X
Classification and external resources
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Cardiac syndrome X is angina (chest pain) with signs associated with decreased blood flow to heart tissue but with normal coronary arteries. Cardiac syndrome X is sometimes referred to as 'microvascular angina' when there are findings of microvascular dysfunction.

Some studies have found increased risk of other vasospastic disorders in cardiac syndrome X patients, such as migraine and Raynaud's phenomenon. It is treated with beta-blockers, such as metoprolol, and usually carries a favorable prognosis.

This is a distinct diagnosis from Prinzmetal's angina.

While there is no formal definition for cardiac syndrome X, the general consensus is that it entails all of the following:

The is no specific known cause for syndrome X, but rather a multitude of risk factors that act together. It is believed that the lack of blood flow caused by a microvascular disease and enhanced pain perception are two of the factors that may cause it. The microvascular dysfunctions refer to the abnormalities in the very small blood vessels of the heart. The narrowing of these vessels may lead to lack of oxygen in specific areas of the cardiac muscle causing chest pain. Several studies have shown that patients suffering from syndrome X have enhanced pain perception, and usually feel more intense chest pain than individuals without syndrome X.

The risk factors include abdominal obesity, meaning excessive fat tissue in and around the abdomen, atherogenic dyslipidemia which is a blood fat disorder, and elevated blood pressure. Other risk factors are insulin resistance or intolerance to glucose, prothrombotic state or proinflammatory state. Older people are more at risk to develop this condition, and there is some evidence that suggests that there are genetic mutations that predispose to the syndrome. Women are more prone to this condition than men, as well as those who have a history of heart disease in the family.

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