Cardiac syndrome X: An overview

Abstract

Patients with cardiac syndrome X (CSX), defined as typical chest pain associated with electrocardiographic changes suggestive of transient myocardial ischemia despite normal coronary angiograms, continue to constitute a diagnostic and a therapeutic challenge. CSX is not a rare syndrome, as up to 50 % of patients undergoing diagnostic angiography for the assessment of typical chest pain are found not to have obstructive coronary artery disease. CSX encompasses a variety of pathogenic subgroups and is most typically seen in peri- and postmenopausal women. The condition can impair the patient's quality of life, is associated with an adverse prognosis in certain patient subgroups, and represents a substantial cost burden to the healthcare system. Not infrequently, a lack of understanding of the pathogenesis of the syndrome by the treating physician results in poor management of the condition. Treatment remains elusive, but management strategies exist that can improve the patient's quality of life and wellbeing. Clinical trials are needed to evaluate the impact of management strategies on major adverse cardiac events. The present book addresses most of the important issues relevant to the understanding of the condition including its epidemiology, pathogenesis, diagnosis and effective management strategies.