Syndrome X is usually diagnosed after a treadmill test which has proven to be positive. This positive exercise ECG (electrocardiography) means that patient’s heart does not get sufficient amount of blood during the exercise. After that, patients need to have an angiogram. Doctors will use X-rays to see the arteries of the heart and check for any blockage of these arteries. Angiogram cannot record any of microvascular dysfunctions, but it can provide valuable information about arteries. Patients without any narrowing or blockage of these blood vessels and without any other cause of chest pain are usually diagnosed with syndrome X. Some patients may need further tests to exclude Prinzmetal’s angina as the cause of their chest pain.
In most cases syndrome X patients are not exposed to greater risk of developing a heart attack or some other lethal heart problems. These patients are advised to be regularly tested for their chest pain, presumably in hospital environment.
Treatment Options for Syndrome X
This syndrome may be treated with different medications. Most doctors usually prescribe nitrates to patients suffering from syndrome X. These drugs should relax heart muscles and blood vessels, increasing blood flow and relieving the pain. However, this treatment may not work for half of syndrome X patients and they simply do not respond adequately.
Another treatment option includes medications used for high blood pressure such as beta blockers and calcium channel blockers. About 30% of these patients respond well to calcium channel blockers, while beta blockers improve the symptoms and ease chest pain in more than 65% of syndrome X patients.
Patients suffering from syndrome X may also have enhanced perception of pain. Therefore, some doctors may prescribe an antidepressant drug called imipramine (Tofranil). In some studies Tofranil has proven to decrease frequency of chest pain in women treated with this drug. The problem with imipramine is the incidence of side effects present in large number of patients (83%). Some patients suffer from extremely bad side effects and they have to stop using the drug.
Estrogen replacement therapy has also been studied as a treatment option for syndrome X in menopausal women. Estrogen patches were found to relieve the episodes of chest pain but have also been associated with increased risk of blood clots and heart attack.
Syndrome X Prevention
No one knows the exact cause of syndrome X and, therefore, no one can tell what to do to prevent this medical issue. Heart-healthy lifestyle is always recommended by doctors. This includes healthy diet, regular physical activity, lowering of high blood pressure and healthy cholesterol level and probably the most significant thing – smoking cessation.