Document Detail


Cardiac syndrome X in women: the role of oestrogen deficiency.
MedLine Citation:
PMID:  16614266     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J C Kaski
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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    
Affiliation:
Cardiovascular Research Centre, Division of Cardiac and Vascular Sciences, St George's Hospital Medical School, University of London, London SW17 0RE, United Kingdom. jkaski@sghms.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Endothelium, Vascular / physiopathology
Estrogens / deficiency*,  physiology
Female
Hormone Replacement Therapy / methods
Humans
Microcirculation
Microvascular Angina / etiology*,  physiopathology
Myocardial Ischemia / etiology
Nociceptors / physiology
Chemical
Reg. No./Substance:
0/Estrogens
Comments/Corrections

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