Women, Cardiac Syndrome X, and Microvascular Heart Disease

Abstract New data suggest that persistent chest pain, despite normal coronary angiography, is less benign than previously thought. It has long been recognized that cardiac syndrome X (CSX) is associated with significant suffering, disability, and health care costs, but the biggest shift in thinking...

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Bibliographic Details
Published in:Canadian journal of cardiology 2012-03, Vol.28 (2), p.S42-S49
Main Authors: Arthur, Heather M., PhD, FESC, Campbell, Pat, RN, BScN, MBA, Harvey, Paula J., BMBS, PhD, FRACP, McGillion, Michael, RN, PhD, Oh, Paul, MD, MSc, FRCPC, Woodburn, Elizabeth, Hodgson, Corinne, MA, MSc
Format: Article
Language:English
Subjects:
Canada - epidemiology
Cardiovascular
Chest Pain - metabolism
Chest Pain - physiopathology
Coronary Angiography - methods
Coronary Vessels - metabolism
Coronary Vessels - physiopathology
Cost of Illness
Disease Management
Female
Humans
Interdisciplinary Communication
Microvascular Angina - diagnosis
Microvascular Angina - epidemiology
Microvascular Angina - etiology
Microvascular Angina - physiopathology
Microvascular Angina - therapy
Microvessels - metabolism
Microvessels - physiopathology
Myocardial Ischemia - complications
Myocardial Ischemia - metabolism
Myocardial Ischemia - physiopathology
Postmenopause - metabolism
Prognosis
Risk Factors
Stress, Psychological - etiology
Time
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Summary:Abstract New data suggest that persistent chest pain, despite normal coronary angiography, is less benign than previously thought. It has long been recognized that cardiac syndrome X (CSX) is associated with significant suffering, disability, and health care costs, but the biggest shift in thinking comes in terms of long-term risk. It is now recognized that the prognosis is not benign and that a significant proportion of patients are at increased cardiovascular disease risk. Of major debate is the question of whether the mechanisms that explain this chest pain are cardiac vs noncardiac. The most current definition of CSX is the triad of angina, ischemia, and normal coronary arteries, which is associated with an increased cardiovascular risk. This paper provides a review of CSX, epidemiology of the problem, proposed explanatory mechanisms, and important next steps in research. Central to this review is the proposition that new insights into CSX will be fostered by both clinical and scientific collaboration between cardiovascular and pain scientists.
ISSN:0828-282X
1916-7075
DOI:10.1016/j.cjca.2011.09.006