Document Detail

Cardiac syndrome X in women: the role of oestrogen deficiency.
MedLine Citation:
PMID:  16614266     Owner:  NLM     Status:  MEDLINE    
Cardiac syndrome X (CSX), defined as typical exertional chest pain, a positive response to stress testing, and normal coronary arteriograms, encompasses different pathogenic subgroups. Both cardiac and non-cardiac mechanisms have been suggested to play a pathogenic role, and it has been shown that the syndrome is associated with myocardial ischaemia in at least a proportion of patients. Radionuclide myocardial perfusion defects, coronary sinus oxygen saturation abnormalities and pH changes, myocardial lactate production and stress-induced alterations of cardiac high energy phosphate have been reported in CSX patients, suggesting an ischaemic origin for their symptoms. Microvascular abnormalities often caused by endothelial dysfunction appear to be responsible for myocardial ischaemia in these patients. CSX is more prevalent in women than in men, and the majority of women with CSX are peri- or post-menopausal. Thus oestrogen deficiency has been suggested to have a pathogenic role in CSX. Additional factors such as abnormal pain perception may also contribute to the genesis of chest pain in patients with angina and normal coronary angiograms. The management of this syndrome is difficult because of the heterogeneity of pathogenic mechanisms and uncertainties as to its origin. This article discusses the problem of CSX in women, the potential pathogenic role of oestrogen deficiency, and practical clinical management.
J C Kaski
Related Documents :
2032406 - Long-term clinical course of patients with angina and angiographically normal coronary ...
16603266 - Ventricular tachycardia in an ice-hockey player after a blunt chest trauma.
18402806 - Multiple hydatid cystectomy of the heart necessitating lima to lad anastomosis in a you...
17292526 - A pregnant woman with acute myocardial infarction due to coronary artery dissection: pr...
6744696 - Echocardiographic features of right ventricular infarction.
9078836 - A medico-legal approach to the myocardial changes caused by transthoracic direct curren...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  92 Suppl 3     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-14     Completed Date:  2006-06-14     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  iii5-9     Citation Subset:  AIM; IM    
Cardiovascular Research Centre, Division of Cardiac and Vascular Sciences, St George's Hospital Medical School, University of London, London SW17 0RE, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Endothelium, Vascular / physiopathology
Estrogens / deficiency*,  physiology
Hormone Replacement Therapy / methods
Microvascular Angina / etiology*,  physiopathology
Myocardial Ischemia / etiology
Nociceptors / physiology
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Coronary revascularisation in women.
Next Document:  Economic evaluation of the impact of nicorandil in angina (IONA) trial.