title: Cardiac syndrome X: Clinical characteristics revisited.
abstract: BACKGROUND
  Cardiac syndrome X includes a heterogenous group of patients with angina but normal epicardial coronaries in angiography.
  
  
  OBJECTIVE
  Our objective was to study the clinical characteristics of patients with cardiac syndrome X.
  
  
  METHODS
  Data of patients who underwent coronary angiography over a period of one year was retrospectively analyzed. Those with normal or non-obstructive coronaries in angiography with chest pain were included in this study.
  
  
  RESULTS
  1203 patients underwent coronary angiography during the study period. 105 (8.7%) patients fulfilled the inclusion criteria. There were 52 (49.5%) males and 53 (50.5%) females including 31 (29.5%) postmenopausal women. Many patients had atherosclerotic risk factors. Typical angina and atypical chest pain were reported by 63 (60%) and 42 (40%) patients, respectively. ECG was normal in 46 (43.8%) and abnormal in 59 (56.2%) patients. The most common abnormal finding in ECG was ST-T changes seen in 49 (46.7%) patients. Regional wall motion abnormality with mild left ventricular systolic dysfunction was seen in 4 (3.8%) patients while 101 (96.2%) patients had normal ventricular function in echocardiography. TMT was positive for inducible ischemia in 35 (33.3%) patients and inconclusive in 10 (9.5%) patients. Angiography showed normal epicardial coronaries in 85 (80.9%) patients.
  
  
  CONCLUSIONS
  Cardiac syndrome X constitutes a significant subset of patients undergoing coronary angiography. It is essential to identify and treat them specifically for microvascular angina. Many of them have atherosclerotic risk factors but their presentation is different from those with obstructive coronaries.
authors: Department of Cardiology, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India. Electronic address: drebabu@gmail.com.
authors: Babu
authors: B
authors: Ezhumalai
authors: Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors: Ajith
authors: A
authors: Ananthakrishnapillai
authors: Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors: Raja J
authors: RJ
authors: Selvaraj
authors: Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors: Santhosh
authors: S
authors: Satheesh
authors: Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors: Balachander
authors: B
authors: Jayaraman
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D017566:Microvascular Angina / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Cardiac syndrome X; Coronary angiography; Non-obstructive coronaries; Normal epicardial coronaries; Syndrome X