Cardiac syndrome X: Management algorithms

Abstract

The management of cardiac syndrome X (CSX) often represents a challenging task for the managing physician. The syndrome encompasses heterogeneous patient categories with different pathophysiological and etiological backgrounds. Each of these patient subgroups may require different therapeutic approaches, depending on the prevailing pathogenic mechanism. In addition, within groups, some patients but not others may respond favourably to different forms of treatment. Coronary microvascular dysfunction is one of the prevailing pathogenic mechanisms and can result in impaired coronary vasodilation, excessive coronary vasoconstriction or both. Identifying the prevailing pathogenic mechanisms should result in the implementation of effective treatment strategies. This chapter focuses on the practical management of patients with CSX.