title: [Typical angina pectoris complaints without coronary macroangiopathy].
abstract: METHODS
  A 46-year-old patient with repetitive chest pain on exercise and exclusion of coronary heart disease was transferred for further diagnostic evaluation and therapy because of the suspicion of cardiac syndrome X.
  
  
  METHODS
  Coronary angiography showed no evidence for a stenotic coronary heart disease. However, a decreased coronary blood flow reserve was detected upon adenosin treatment (RCA), and myocardial scintigraphy (single-photon emission tomography-investigation [SPECT]) revealed a perfusion defects in the inferior wall.
  
  
  METHODS
  Endothelial dysfunction (syndrom X) was diagnosed and an optimised therapy regime was initiated in order to improve endothelial function.
  
  
  CONCLUSIONS
  In patients with typical angina pectoris and positive treadmill exercise stress test in the absence of stenotic coronary heart disease, cardiac syndrome X should be considered, and further invasive- and non-invasive tests should be performed. Therapeutic goals should be to improve endothelial function and to control chest pain and improve quality of life.
authors.affiliation: Klinik III für Innere Medizin, Labor für Herzmuskelphysiologie und Molekulare Kardiologie, Universität zu Köln.
authors.forename: S
authors.initials: S
authors.lastname: Grönke
authors.forename: M
authors.initials: M
authors.lastname: Schmidt
authors.forename: R H
authors.initials: RH
authors.lastname: Schwinger
mesh_terms: D002637:Chest Pain / Q000517:prevention & control; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D011788:Quality of Life; D015899:Tomography, Emission-Computed, Single-Photon