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What is Syndrome X??
The term Cardiac Syndrome X was first used in 1973 to describe a condition that to this day remains a bit of a mystery.
Syndrome X is a very rare and serious cardiac disease. To have Syndrome X means that the patient get spasms in the smaller blood vessels on the heart. This results in that the vessel contracts and the blood supply to the heart muscle stops, and the angina pectoris appears.
Where normally it´s men that get heart diseases, with Syndrome X you´ll see the opposite. Here 70-80% of the patients with Cardiac Syndrome X are women. The disease normally starts when the patients are between 45-55 years old. Why specifically it strikes this group of women is at this point unknown.
However a theory as to what causes Syndrome X is that the lining of the walls of these smaller blood vessels function poorly as a consequence of high cholesterol levels or low levels of oestrogen. Supporting this theory is the fact that Cardiac Syndrome X is more common in post-menopausal women, who are more likely to be oestrogen deficient.
Syndrome X is a diagnose that is made, when all other options have been ruled out.
How does it feel?
It varies from patient to patient, but generally it's shortness of breath and the feeling of pressure on the chest. At times a painful pressure related to a lack of oxygen in the heart muscle. The pain often goes up into the neck, towards the shoulders and sometimes even out to the arms.
Women's symptoms can be somewhat difficult to interpret and is more diffuse, but they must be taken seriously. Symptoms can occur alone or several at the same time. They can come, and go, and then come back and they need not be accompanied by pain. Symptoms may arise from psychological stress or physical activity. Symptoms in women can be:
- Discomfort in the chest region - an oppressive or tightening sensation
- Breathlessness that can occur alone or together with the unpleasant tightness in chest
- Palpitations
- Dizziness, nausea or vomiting
- Sweat
- Pain / discomfort in both arms, between the shoulder blades, neck and jaw
- Unusual tiredness
- Sleep disorders
- Digestive Problems and / or a painful sensation of gas
- A feeling that something is quite wrong
What can trigger an attack?
Several things can trigger an attack of Syndrome X. Cold weather, a big meal, physical and psychological stress, smooking, and some times they can come completely unprovoked. It's not unusual for the patient to have an attack while at rest, rather then when moving. It's important to remember, that this condition is not a life-threatening one.
Treatment of Syndrome X?
Patients with Cardiac Syndrome X are often treated with calcium channel blockers, nitroglycerin tablets and Nitromex for an acute attack. These can relieve the symptoms of chest pain and lessen the frequency of painful episodes. In severe cases it may be necessary to give morpine, but it's usually only something that is being used as a last resort.
But one has to realise that the purpose with the medical treatment is to relieve the symptoms, because at this time there does not exist a cure for Cardiac Syndrome X.
If you are a smoker and have Prinzmetal Variant Angina
Smoking can provoke angina attacks, so it is strongly recommended that as a patient with Cardiac Syndrome X you don't smoke.
But if you already are a smoker and want to stop, you must be very careful not to use nicotine products such as Nicorette. If you read the leaflet in these products is actually advise against the use of Nicorette to people with "Prinzmetal variant angina, unstable / stable angina." So there is no easy way for this group of people to quit smoking.
Your future if diagnosed with Syndrome X?
The outlook for patients with Cardiac Syndrome X is good. They're much less likely to develop a heart attack than those people with narrowing of the major coronary arteries. However, this doesn't mean they can afford to be complacent about their lifestyle. It's still important for patients to look after their heart and blood vessels by not smoking, eating healthily and keeping active within their capabilities.
Sadly though the fact is, however, that many because of pain and fatigue due to the Cardiac Syndrome X, find it difficult to maintain the life they had before the illness beginning. Some patients have great difficulty in coping with their work, and some are even forced into early retirement.
Are Prinzmetal's Variant Angina and Syndrome X the same?
No, they are not the same. The difference between Prinzmetal's Variant Angina and Syndrome X is in which vessels the angina is. With Prinzmetal's Variant Angina the angina occurs in the major arteries and with Syndrome X they occur in the smaller arteries on the heart. Another distinct difference is that Prinzmetal's Variant Angina can develop to a deadly disease, and cause heart failure. Where Syndrome X is not a deadly disease. Besides that, the symptoms and treatments are exactly the same.
Source: Hjerteforeningen
Note: Some of the used informations are from a lecture with Hans Erik Bøtker, from May 2005.
This article was last updated on 03. October 2009
You can read the German translation of the article here: Herzsyndrom X |
