Clinical Analysis Of Cardiac Syndrome X 59 Cases

Objective:To improve the understanding of cardiac syndrome X, and to explore its possible pathogenesis.Methods:The clinical features and examination results of 59 patients with cardiac syndrome X were analyzed retrospectively.Result:All of the 59 cases underwent conventional ECG, 10 of them were normal, 49 of them had ischemic ST-T changed or Q waves rational sick. And ischemic ST-T changes on Holter electrocardiographic monitoring were recorded in 20 cases, especially after the apparent activity.The results of coronary angiography in all 59 cases did not meet the criteria for the diagnosis of coronary artery stenosis. For security reasons, we did the intracoronary nitroglycerin injection instead of ergonovine test while doing coronary angiography, and there was no ST-segment elevation in ECG when chest pain occurred, except for coronary artery spasm.Static myocardial perfusion tomography showed that, there were single local blood perfusion slightly decreased in 27 cases, partial reversibility of myocardial ischemia in 5 cases, and no obvious abnormalities in other 8 cases.Markedly after medication: 15 of the 59 cases relieved after sublingual nitroglycerin administration, and there were no significant mitigating factors in the other cases.The clinical manifestations ,ECG, exercise testing, load radionuclide myocardial perfusion tomography, ease way of chest pain in patients with cardiac syndrome X are very similar to normal coronary angiography.Conclusion:1.Coronary angiography is the only way to identify the cardiac syndrome X and coronary heart disease.2.The possible pathogenesis of cardiac syndrome X is the reduced coronary flow reserve caused by the minimal coronary vascular disease, endothelial dysfunction,inflammation ,insulin resistance and abnormal levels of estrogen.3. Until now there is no special medicine which can release the patients' angina pectoris and improve life quality for cardiac syndrome X now.4. The prognosis of the cardiac syndrome X is favourable, but there are lot of patients have chest pain, and requir drug therapy.