Cardiac Syndrome X: Update

Shilpa Agrawal; Puja K Mehta; C Noel Bairey Merz

doi:10.1016/j.hfc.2015.08.012

Cardiac Syndrome X: Update

Heart Fail Clin. 2016 Jan;12(1):141-56. doi: 10.1016/j.hfc.2015.08.012.

Authors

Shilpa Agrawal¹, Puja K Mehta², C Noel Bairey Merz³

Affiliations

¹ David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
² Department of Medicine, Cedars-Sinai Medical Center, Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, 127 South San Vicente Boulevard, Los Angeles, CA 90048, USA. Electronic address: puja.mehta@cshs.org.
³ Department of Medicine, Cedars-Sinai Medical Center, Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, 127 South San Vicente Boulevard, Los Angeles, CA 90048, USA.

PMID: 26567981
DOI: 10.1016/j.hfc.2015.08.012

Abstract

Cardiac Syndrome X (CSX), characterized by angina-like chest discomfort, ST segment depression during exercise, and normal epicardial coronary arteries at angiography, is highly prevalent in women. CSX is not benign, and linked to adverse cardiovascular outcomes and a poor quality of life. Coronary microvascular and endothelial dysfunction and abnormal cardiac nociception have been implicated in the pathogenesis of CSX. Treatment includes life-style modification, anti-anginal, anti-atherosclerotic, and anti-ischemic medications. Non-pharmacological options include cognitive behavioral therapy, enhanced external counterpulsation, neurostimulation, and stellate ganglionectomy. Studies have shown the efficacy of individual treatments but guidelines outlining the best course of therapy are lacking.

Keywords: Angina; Cardiac syndrome X; Ischemia; Microvascular endothelial dysfunction; Myocardial hypersensitivity.

Publication types

Review