Abstract
The term “syndrome X”, in its strict definiition, includes patients with exertional chest pain usually indistinguishable from atherosclerotic coronary artery disease, a positive exercise test and completely normal coronary angiography. Left ventricular hypertrophy, coronary artery spasm, conduction defects and valvular heart disease are normally excluded from this definition [1–4]. The possible role of myocardial ischemia in the pathogenesis of syndrome X has been supported by the observation, in some patients, of coronary sinus lactate production during atrial pacing [5,6], the demonstration of abnormal left ventricular systolic function during exercise [6] and the presence of reversible defects by thallium scintigraphy [7–9]. Objective evidence of myocardial ischemia is however rarely found in patients with syndrome X. Several authors have failed to demonstrate myocardial perfusion defects or hemodynamic abnormalities in well characterised syndrome X patients [10,11].
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Nihoyannopoulos, P. (1999). The Role of Echocardiography in Diagnosis and Management of Cardiac Syndrome X. In: Kaski, J.C. (eds) Chest Pain with Normal Coronary Angiograms: Pathogenesis, Diagnosis and Management. Developments in Cardiovascular Medicine, vol 213. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5181-2_16
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DOI: https://doi.org/10.1007/978-1-4615-5181-2_16
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