Cardiac Syndrome X
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An unexplained and abnormal angina (chest pain) might be a Cardiac Syndrome X (CSX). Although anybody can get affected by the CSX, but by far, yet it is usually the young women (Pre-menstrual) who are most afflicted by this disease.

Cardiac Syndrome X Causes

The main causes of this syndrome are the decrease in the flow of the blood to heart muscle, which in return might be owing to some other factors like microvascular dysfunction. Other reason might be the "hypersensivity" towards the cardiac pain. Microvascular dysfunction is a condition when the smaller arteries supplying blood to the heart become narrowed, thus reducing the blood flow.

The angina is usually experienced while undergoing some form of exercise or exertion. People suffering from this disease might face other resulting diseases like migraine and Raynaud's phenomenon. Also, doctors believe that certain type of Psychiatric disorders like panic attacks might also be the result of CSX, though this might be a secondary condition associated to the disease rather than a primary one. Other syndromes such as Fibromygalia and inappropriate sinus tachychardia are also linked with CSX.

Symptoms of Cardiac Syndrome X

There is no specific test designed to diagnose the Cardiac Syndrome X. While there are other ways to diagnose the Cardiac Syndrome X, the chief one is to rule out any other reasons like Prinzmetal's angina, Esophageal spasm, gastrovascular problems causing the chest pain.

Also by performing the cardiac catharization, if the results are normal coronary arteries and no inducible coronary artery spasm is found, the possibility of CSX is heightened. The other few parameters, which can be followed to test for the CSX are -- firstly, Abnormal Cardiac Stress Test. This when the patient is asked to excercise (chiefly walking on the treadmill). Due to the exertion, if the heart starts paining and the stress ECG (Eco-Cardiogram) shows positive results, the disease can be diagnosed. While an angiogram (X-Ray dye test of the coronary arteries), performed might not yield the desired results.

The reason for this is that in the microvascular dysfuunction, the arteries involved are too small to show any irregularities in the angiogram. There is another test being used by researchers these days to diagnose CSX -- MRI scanning to demonstrate the abnormal blood-flow to the heart after using provocative testing like adenosine or dobutamine infusions. Though this is not a routine test performed, but this test proves best the association of true psychological abnormality with the patient's chest pain.

Treatment for Cardiac Syndrome X

Once the Cardiac Syndrome X is successfully diagnosed, the treatment can be given. CSX can be treated with various additives like the calcium channel brokers (like nifedipine and diltiazem), nitrates, Beta blockers, imipramine, aminophyllamine (which might work by inhibiting the adenosime receptors) and estrogen (only for women). The mentioned first three (i.e. Calcium channel brokers, nitrates and beta-blockers) are effective as they reduce the chest pain and the frequency of the painful spasms.

Due to the lack of association to any long-term cardiac disorder, usually the pain-control therapy works. Those patients suffering from the signs of Inappropriate Sinus Tachycardia (i.e. an increase in the sympathetic tone) should be administered with beta blockers. If none of the drugs work, imipramine should be administered. If it's the case of a post-menopausal women suffering from CSX, Hormone Replacement Therapy (HRT) can be an effective way of controlling the disease, however one should be cautious of the negative effects of HRT.


Researches have shown that CSX does not have any major risk at the health of the patient. The development of heart attacks or cadiomypathy (i.e. Heart muscle disease and heart failure) is absent from the patients suffering from this disease. Though the risks are minimal, this does not levy the patients to get careless about their lifestyles. By avoiding smoking, eating healthy food and staying active by exercising to their highest abilities, the patients can live easily without facing any major problem and live up to their normal life span.

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