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Syndrome X

(Cardiac) syndrome X is angina(Chest Pain) with signs associated with decreased blood flow to heart tissue but with norman Coronary arteries. It occurs more often in young women. Some studies have found increased risk of other vasospastic disorders in Syndrome X patients, such as migraine and Raynaud's phenomenon. It is treated with calcium channel blockers, such as nifedipine, and usually carries a favorable prognosis. This is a distinct diagnosis from Prinzmetal's angina. more...

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Features

While there is no formal definition for Syndrome X, the general consensus is that it entails all of the following:

  • Angina This usually does not cause dysfunction on echocardiogram and can last longer than that of heart disease.
  • Abnormal Cardiac stress test ST changes are typically similar to those of Coronary artery disease and opposite of those with Prinzmetal's angina. Myocardial Perfusion imaging can be abnormal in 30% of patients.
  • Normal Coronary angiogram
  • Other causes of chest pain must be ruled out, including:
    • Prinzmetal's angina
    • Esophageal spasm

Diagnosis

Syndrome X is a diagnosis of exclusion. Typically this will necessitate both a clinical diagnosis, appropriate stress testing, and a coronary angiogram that meet the above criteria.

Pathophysiology

While numerous physiological mechanisms have been proposed, none have been proven.

Treatment

  • nitrates - can reduce chest pain
  • calcium channel blockers - specifically nifedipine can be effective.
  • beta blockers - also work.
  • aminophylline - may work by inhibiting adenosine receptors.
  • estrogen - may work in women.

Read more at Wikipedia.org


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Holistic approach to Syndrome X
From Townsend Letter for Doctors and Patients, 12/1/04 by Katherine Duff

Nutritional Factors for Syndrome X

by Stephen Holt, MD, Jonathan V. Wright, MD, T.V. Taylor, MD and Fraser G.S. Holt

Wellness Publishing, 105 Lock Street, Suite 405, Enterprise Development Center, NJIT, Newark, New Jersey 07103 USA

Paperback, 2003, $19.95, 146 pp.

Most people may not have even heard of it, but Syndrome X affects up to 70 million Americans and accounts for the leading causes of death and disability in this country. As a metabolic syndrome it does not have widespread recognition, which the authors of Nutritional Factors for Syndrome X hope to change. The authors are an impressive group that includes Stephen Holt, MD, Jonathan Wright, MD, T.V. Taylor, MD and Fraser Holt. Their goal in this book is to first of all, put an end to the complacency surrounding this important risk to health, and then to offer a plan to combat Syndrome X through changes in lifestyle and nutritional approaches.

As defined in this book, Syndrome X is caused by a disturbance in body chemistry that arises from inherited tendencies, lack of exercise and too much refined sugar. The indicators of this syndrome include symptoms such as high blood pressure, obesity and high blood cholesterol. At the root of all these problems is resistance to the hormone insulin.

Insulin resistance occurs when the body does not respond properly to insulin. When this happens blood levels of insulin are elevated while the pancreas secretes even more insulin. Excessive circulating insulin tends to increase fat storage, cholesterol production and blood pressure. What follows is a chain of events that cause metabolic disturbances resulting in damage to blood vessels. It is easy to see then why the diseases that result from Syndrome X include heart attack, stroke and vascular diseases, which are the leading causes of death and disability in this country. Syndrome X is also considered a forerunner to Type II, adult onset diabetes.

Treatment for Syndrome X is to address all four of the risk factors rather than each individually, preferably with natural remedies. Obesity must be addressed with weight loss, high blood pressure must be reduced, high cholesterol must be reduced and blunting of surges in blood glucose must be accomplished. For this, they warn against self-treatment and advise the reader to seek the assistance of a knowledgeable physician. They do though, offer practical strategies for developing a healthier lifestyle with more exercise, diet and appropriate supplements.

The discussion of diet stresses that there is no one diet recommendation for everyone, but in general the goal is to limit calories, reduce carbohydrates and limit intake of simple sugars. The authors critique several popular diets and settle on a modified Atkins Diet as their preference.

Figuring prominently in diet consideration is the concept of the Glycemic Index, which refers to the ability of certain foods to raise the level of blood sugar. One factor that can affect sugar absorption is the rate at which the stomach empties. Food choices that include soluble fiber and supplements can slow this rate and subsequently blunt surges in blood sugar.

The supplements discussed in the book are considered "first-line options" for smoothing out blood glucose levels and reducing spikes of insulin. Among those recommended are a properly balanced ratio of omega 6 and omega 3 fatty acids, CoEnzyme Q10, chromium, vanadium and several antioxidants.

This book ends with each of the doctors contributing a chapter with their opinions concerning Syndrome X. Common to these essays is the understanding that Syndrome X represents a new pandemic--as evidenced by the increasing number of overweight adults and children developing diabetes. Rather than turning to pharmaceuticals as the first option for each of the symptoms, this small book offers natural strategies that may prevent or correct many of our most debilitating illnesses.

review by Katherine Duff

COPYRIGHT 2004 The Townsend Letter Group
COPYRIGHT 2004 Gale Group

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