Chest pain with angiographic clear coronary arteries: A provider's approach to cardiac syndrome X

Purpose: To present information about cardiac syndrome X (CSX) including its (a) definition, (b) etiology and pathology, (c) epidemiology, (d) symptomatology, (e) diagnosis, (f) treatment, and (g) prognosis. Clinical recommendations will also be presented. Data sources: Articles used in this review were found by searching CINAHL, Medline, the Cochrane Library, Web of Science (ISI), Academic Search Premier, and Health Source: Nursing/Academic Edition. Conclusions: The causes of CSX remain unknown; however, CSX is easy to diagnose and can be treated. Medication therapy and risk factor modification can greatly improve the quality of life by decreasing pain occurrence and lessening pain intensity. Implications for practice: Too often, providers reassure patients of a healthy heart because of normal coronary arteries despite persistent chest pain and ST segment changes on the electrocardiogram. Chest pain, one of the primary signs and symptoms of CSX, can be reduced through common medications and interventions if the diagnosis of CSX is initiated.

[1]  C. Appleton,et al.  Cardiac syndrome X and endothelial dysfunction: new concepts in prognosis and treatment. , 2006, The American journal of medicine.

[2]  J. Kaski,et al.  Microvascular dysfunction in cardiac syndrome X: the role of inflammation , 2006, Canadian Medical Association Journal.

[3]  J. Kaski,et al.  Cardiac syndrome X in women: the role of oestrogen deficiency , 2006, Heart.

[4]  G. Lanza,et al.  Cardiac syndrome X: a critical overview and future perspectives , 2005, Heart.

[5]  Ş. Korkmaz,et al.  Mean Platelet Volume in the Patients with Cardiac Syndrome X , 2005, Journal of Thrombosis and Thrombolysis.

[6]  A. Lerman,et al.  Management of the patient with chest pain and a normal coronary angiogram. , 2005, Cardiology clinics.

[7]  S. Reis,et al.  Persistent chest pain predicts cardiovascular events in women without obstructive coronary artery disease: results from the NIH-NHLBI-sponsored Women's Ischaemia Syndrome Evaluation (WISE) study. , 2005, European heart journal.

[8]  B. D. Lucas,et al.  Angina with "normal" coronary arteries. , 2005, JAMA.

[9]  C Noel Bairey Merz,et al.  Angina with "normal" coronary arteries. , 2005 .

[10]  J. Kaski.  Pathophysiology and Management of Patients With Chest Pain and Normal Coronary Arteriograms (Cardiac Syndrome X) , 2004, Circulation.

[11]  C. Pizzi,et al.  Angiotensin-Converting Enzyme Inhibitors and 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase in Cardiac Syndrome X: Role of Superoxide Dismutase Activity , 2004, Circulation.

[12]  M. Kayıkçıoğlu,et al.  Benefits of statin treatment in cardiac syndrome-X1. , 2003, European heart journal.

[13]  E. Abinader.  Cardiac syndrome X. , 1995, Journal of the American College of Cardiology.

[14]  R. Cannon,et al.  "Microvascular angina" as a cause of chest pain with angiographically normal coronary arteries. , 1988, The American journal of cardiology.

[15]  Jian‐Jun Li,et al.  Inflammation: a possible pathogenic link to cardiac syndrome X. , 2006, Medical hypotheses.

[16]  A. Domínguez-Rodríguez,et al.  Cardiac Syndrome X: Diagnosis, Pathogenesis and Management , 2004, American journal of cardiovascular drugs : drugs, devices, and other interventions.

[17]  J. Kaski.  Pathophysiology and Management of Patients With Chest Pain and Normal Coronary Arteriograms ( Cardiac Syndrome , 2004 .