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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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Medicines

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.

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Syndrome X is dangerous but preventable - insulin resistance and metabolic syndrome X
From Nutrition Health Review, 3/22/03

According to the Centers for Disease Control and Prevention (CDC), at least 20 percent of Americans have a potentially dangerous condition known as syndrome X, which is sometimes called metabolic syndrome or insulin resistance syndrome.

Gerald Reaven, M.D., a professor of medicine at Stanford University, was one of the first scientist to link high insulin levels with an increased risk of heart disease. He estimates that nearly 60 million to 75 million people are insulin-resistant and susceptible to related health problems. Of those who are insulin-resistant, approximately 5 to 10 ten percent will go on to have adult-onset (type 2) diabetes, with the remaining 90 to 95 percent at risk for development of syndrome X.

In healthy people, insulin allows glucose to move into cells in the body; this process then creates energy. In patients with syndrome X, insulin cannot transport the glucose, causing the pancreas to produce more insulin to normalize blood glucose levels.

The cause of syndrome X is unknown, but scientists believe that roughly 50 percent of cases result from genetic variations. The syndrome is also believed to be the result of body weight--particularly the presence of abdominal fat--and fitness level. Obese people are more prone to the development of insulin resistance, but it is possible to be insulin-resistant and have a normal body weight.

Although specific dietary changes aimed at reducing insulin resistance are debated, most experts agree that a 10 percent reduction in body weight is beneficial. Keith Ayoob, a registered dietitian and spokesperson for the American Dietetic Association, believes that small changes can ease the danger of syndrome X.

"It's not about achieving a perfect lifestyle but instead working towards a better one," he says. He also discourages people from attempting to follow fad diets in order to lose weight. He recommends a diet high in fiber, low in fat, and rich in fruits and vegetables, coupled with moderate physical activity and a positive attitude.

COPYRIGHT 2003 Vegetus Publications
COPYRIGHT 2003 Gale Group

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