cardiac syndrome X

Epidemiology

• women

Pathology

• decreased blood flow to heart tissue
• normal coronary arteries

Clinical manifestations

• angina pectoris
• chest pain on exertion

Diagnostic procedures

• 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

More general terms

• angina pectoris