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Syndrome X (Microvascular Angina)

By

Ranya N. Sweis

, MD, MS, Northwestern University Feinberg School of Medicine;


Arif Jivan

, MD, PhD, Northwestern University Feinberg School of Medicine

Last full review/revision Jul 2020| Content last modified Jul 2020
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Syndrome X is cardiac microvascular dysfunction or constriction causing angina in patients with normal epicardial coronary arteries on angiography.

Patients with cardiac syndrome X have

Some of these patients have ischemia detected during stress testing; others do not. In some patients, the cause of ischemia seems to be reflex intramyocardial coronary constriction and reduced coronary flow reserve. Other patients have microvascular dysfunction within the myocardium: The abnormal vessels do not dilate in response to exercise or other cardiovascular stressors; sensitivity to cardiac pain may also be increased.

The mainstay of treatment is controlling risk factors with lipid lowering therapy and glycemic control. In many patients, traditional anti-ischemic treatment, including beta-blockers and calcium channel blockers, helps to relieve symptoms (1 General reference Syndrome X is cardiac microvascular dysfunction or constriction causing angina in patients with normal epicardial coronary arteries on angiography. (See also Overview of Coronary Artery Disease... read more ).

General reference

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