The Role of Echocardiography in Diagnosis and Management of Cardiac Syndrome X

  • Petros Nihoyannopoulos
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 213)


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, 2, 3, 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, 8, 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].


Myocardial Blood Flow Hypertrophic Cardiomyopathy Wall Motion Abnormality Stress Echocardiography Mitral Valve Prolapse 
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© Springer Science+Business Media New York 1999

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  • Petros Nihoyannopoulos

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