What is Syndrome “X”?
If the medical scientists can not dig out the cause of any disease or fail to solve any other medical problem they use the term “X”. In reality X means cause is not known. Some people get angina or angina like chest pain without any blockage in their coronary artery. This is called syndrome “X”. Their rest ECG is usually normal. In 20% of cases their stress test may be positive for heart pain. These patients complain of chest pain but their coronary angiogram is normal without any block. Now question is that why these people get angina like chest pain though does not have any block. There are certain explanations; in coronary angiography we can only see the large arteries but we can not see smaller arteries so there is possibility that these patients are having disease in these small vessels which can not be seen in angiogram. Second possibility is that these patients may have abnormal vasodilator reserve which means that can not dilate and constrict their coronary arteries like normal people. This type of chest pain with normal ECG and normal coronary angiogram is frequently found in women. This can lead to multiple medical consultations and be responsible for a great deal of anxiety. Some researchers have found that 66% of patients with chest pain simulating heart pain with normal coronary artery have some psychiatric (mental) disorders. Their long term prognosis is very good. They usually do not develop heart attack. These patients require assurance and proper antagonist group of drugs like nifedipine, diltiazem, amlodipine work excellently in this situation. Tricyclic antidepressant may be effective in some patients. Behavioral therapy may teach the patient with pain how to function more effectively.
