What is Cardiac Syndrome X?

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A patient is said to have Cardiac Syndrome X if he is suffering from  chest pain associated with angina, even though there isn’t any blockage in the coronary arteries. Patients who’ve had angina describes the condition as a squeezing or suffocating sensation inside their chest. This is unlike a heart-attack and the heart muscle is not damaged interminably, while the pain subsides upon resting. Angina attacks occur due to coronary artery disease (CAD), when the heart needs extra oxygen-rich blood as in the case of exercising.

Patients suffering from cardiac syndrome X exibhit the pain associated with angina but they do not have CAD, i.e their coronary arteries are free from any blockages. No specific cause is known for Syndrome X. Usually a myriad risk factors exist that act together leading to the condition. The lack of blood flow caused by a microvascular disease and the enhanced pain perception can be two factors of the syndrome.

Causes of Cardiac Syndrome X

Risk factors include abdominal obesity which is a result of excessive fat tissue in and around the abdomen. Another reason might be atherogenic dyslipidemia, a blood fat disorder, and elevated blood pressure. Additional risk factors include insulin resistance or glucose intolerance and prothrombic state or proinflammatory state. Women are statistically more prone to this syndrome than men, especially those who’ve had a history of heart disease in their family.

Diagnosis of Cardiac Syndrome X

Your heart’s electrical activity is measured both while sitting relaxed and while exercising, using a baseline electrocardiogram (ECG or EKG).
A nuclear stress test (exercise radioisotopic test) is done where a radioactive substance is injected into the bloodstream. The flow through the arteries is examined by the doctor to determine if your heart muscle is damaged.
Sound waves are employed in a process called echocardiography to produce an image of the heart and it’s working.
By performing coronary angiography,  a dye is introduced into the bloodstream via an injection to give the doctor an x-ray movie of the heart action as the blood flows through it. It should be noted that in patients with CAD, this test shows the blocked artery but in the case of syndrome X, the results are completely normal. So, if the doctor obtains an abnormal exercise stress test and a normal coronary angiogram then the patient is considered to have syndrome X. 

Treatment of Syndrome X

Nitrates are used as medication to stop the chest pain. Nitroglycerin widens the blocked arteries to improve blood flow. Nitrates, however, prove to be ineffecient in almost half the patients it’s administered to. 
Alternative to nitrates include calcium channel blockers or beta blockers that reduce the chest pain by relaxing muscle cells found on the lining of the artery thus improving blood flow while lowing blood pressure. Oxygen demand of the heart is also reduced by these medicines. Aminophylline as well as estrogen works in the case of women. 
Consulting your physician and bringing about lifestyle changes also contribute to tackling and preventing the occurence of this syndrome. Patients are recommended to follow a healthy diet low in saturated fats coupled with regular physical activities.
You may have to try a variety of these treatments before figuring out which is the most optimum for you.

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