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Jun 10, 2013

Inflammation Associated With Cardiac Syndrome X

Study shows inflammation may play important role in patients with unexplained chest pain.

In most cases, people experience chest pain as a result of plaque buildup in the arteries. Over time, plaque can stick to artery walls, which reduces blood flow to the heart and increases risk for heart attack. Fortunately, there are many ways to treat this condition, which can minimize symptoms and lower cardiovascular risk. However, not all cases are so clear cut.

Some patients have a mysterious condition called cardiac syndrome X, where they have perfectly healthy arteries yet experience unexplained chest pain. To this date, we lack a full understanding of cardiac syndrome X and are unclear on the causes, possible complications, and ways to treat this condition. However, a recent study published in the Journal of the American College of Cardiology identified an important link between cardiac syndrome X and inflammation in the arteries.

Inflammation or swelling in the arteries is closely associated with heart disease risk, and is measured using C-reactive proteins—important markers of inflammation found in the blood. In this study, researchers enrolled 21 patients with cardiac syndrome X and measured their levels of inflammation using a test for C-reactive protein. They also used a positron emission tomography (PET) scan to test blood flow and see how healthy patients’ arteries were. After analysis, researchers found that patients with cardiac syndrome X and inflammation had less-healthy blood flow compared to those without inflammation. And less than normal blood flow can be a sign of small vessel disease, also referred to as coronary microvascular disease, which can increase risk for a heart attack.

So what does this study tell us about the mysterious cardiac syndrome X? This was the first study to show a direct relationship between inflammation, reduced blood flow and cardiac syndrome X in patients without the usual risk factors for heart disease. Patients in this study were otherwise healthy individuals, and experienced unexplained chest pain with no sign of heart disease. Although we don’t know exactly what causes cardiac syndrome X, it’s possible that inflammation may play an important role in this condition. And the closer we get to understanding the cause of cardiac syndrome X, the more we can do to help treat and relieve symptoms, and improve outcomes in patients with this condition.
Read the full article in the Journal of the American College of Cardiology—Cardiovascular Imaging

Questions for You to Consider

  • What is cardiac syndrome X?
  • Cardiac syndrome X occurs when a patient with healthy arteries experiences unexplained chest pain, called angina. Most patients with angina have coronary artery disease, or a buildup of plaque in the arteries, which can restrict or block blood flow. Patients with cardiac syndrome X, however, experience chest pain but have no blockage in their arteries.
  • Who is at risk for angina?
  • Those at greatest risk for angina include individuals with heart disease, diabetes, high blood pressure, high cholesterol, or a family history of heart disease. Excess stress, smoking, older age and a lack of exercise can also increase risk for angina. Fortunately, most of these risk factors can be reduced by working with your doctor and making positive lifestyle changes.

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