title: Evolving strategies for the treatment of microvascular angina in women.
abstract: Microvascular angina, also known as cardiac syndrome X, is characterized by anginal chest pain, at least one cardiovascular risk factor, an abnormal stress test and normal coronary arteries on angiography. It is significantly more common in women than in men. A definitive diagnosis of microvascular angina can be made by invasive or noninvasive methods; a presumptive diagnosis can also be made based on fulfillment of diagnostic criteria. Effective treatment of microvascular angina requires aggressive risk factor modification; exercise is one of the most effective treatment modalities. Several other treatment strategies have been shown to relieve anginal symptoms as well as improve vascular function; these include β-blockers, angiotensin-converting enzyme inhibitors, ranolazine, L-arginine, statin drugs and potentially estrogen replacement therapy. Nitrates may be effective for symptom relief. Further studies are required to determine whether specific treatments are associated with improved survival as well as decreased symptoms.
authors.affiliation: Cardiology Section, Veterans Affairs Ann Arbor Healthcare System, Department of Internal Medicine, Division of Cardiology, University of Michigan Health System, Ann Arbor, MI, USA. duvernoy@umich.edu
authors.forename: Claire S
authors.initials: CS
authors.lastname: Duvernoy
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003326:Coronary Circulation / Q000187:drug effects; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D015444:Exercise; D005260:Female; D006801:Humans; D017566:Microvascular Angina / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D055806:Microvessels / Q000187:drug effects; D009131:Muscle, Smooth, Vascular / Q000187:drug effects / Q000503:physiopathology; D011379:Prognosis; D012307:Risk Factors; D016387:Women's Health / Q000639:trends
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors