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Epidemiology of Cardiac Syndrome X and Microvascular Angina

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Book cover Chest Pain with Normal Coronary Arteries

Abstract

Chest pain and normal coronary angiography is seen in up 30 % of patients undergoing the investigation. Despite its notable prevalence, the epidemiology of the condition remains poorly documented. Since the turn of the twentieth century, researchers have been baffled by “unmistakable” angina in the absence of coronary artery disease. Curiosity as to the cardiac aetiology of this chest pain became the focus of several key studies investigating the clinical and haemodynamic features of patients with normal coronary angiography. From these early findings, the cardinal features of three specific disorders associated with normal coronary angiography were established – Cardiac Syndrome X, Microvascular Angina and more recently, the Coronary Slow Flow Phenomenon. Although ambiguity in the literature exists, it is likely that an ‘ischemic’ mechanism for the chest pain in these patients is explained by coronary microvascular dysfunction. It also now understood that despite the absence of significant coronary artery disease, the outcomes of patients are not entirely favourable, with studies suggesting a frequent persistence of chest pain, and increased risk of cardiac events, particularly among women. This chapter will review the available epidemiological data on patients with chest pain and normal coronary angiography, and the clinical features and possible aetiological explanations for the specific coronary microvascular disorders.

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Abbreviations

ACS:

Acute coronary syndrome

CAD:

Coronary artery disease

CHD:

Coronary heart disease

CSFP:

Coronary slow flow phenomenon

GUSTO:

Global utilization of streptokinase and t-PA for occluded coronary arteries

MI:

Myocardial infarction

NCA:

Normal coronary angiography

TIMI:

Thrombosis in myocardial infarction

WISE:

Women’s ischemia syndrome evaluation

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Author information

Authors and Affiliations

  1. Department of Medicine, The Queen Elizabeth Hospital, The University of Adelaide, 28 Woodville Road, Woodville South, Adelaide, SA, 5011, Australia

    Rosanna Tavella PhD, BSc (Hons)

  2. Department of Surgery, The Whiteley-Martin Research Centre, The University of Sydney, Sydney, NSW, 2006, Australia

    Guy D. Eslick DrPH, PhD, FACE, FFPH

Authors
  1. Rosanna Tavella PhD, BSc (Hons)
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  2. Guy D. Eslick DrPH, PhD, FACE, FFPH
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Corresponding author

Correspondence to Guy D. Eslick DrPH, PhD, FACE, FFPH .

Editor information

Editors and Affiliations

  1. Medical School, Coronary Artery Disease, Research Group, St George's Hospital, Cranmer Terrace, London, SW17 0RE, United Kingdom

    Juan Carlos Kaski

  2. University of Sydney, Discipline of Surgery, The Whiteley-Martin Research Centre, Parker Street, Sydney, 2747, New South Wales, Australia

    Guy D. Eslick

  3. , Women's Heart Center, Cedars-Sinai Heart Institute, S. San Vicente Blvd 444, Los Angeles, 90048, USA

    C. Noel Bairey Merz

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Tavella, R., Eslick, G.D. (2013). Epidemiology of Cardiac Syndrome X and Microvascular Angina. In: Kaski, J., Eslick, G., Bairey Merz, C. (eds) Chest Pain with Normal Coronary Arteries. Springer, London. https://doi.org/10.1007/978-1-4471-4838-8_4

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  • DOI: https://doi.org/10.1007/978-1-4471-4838-8_4

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4837-1

  • Online ISBN: 978-1-4471-4838-8

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