Cardiac Syndrome X Clinical Presentation

Updated: Dec 18, 2014
  • Author: Subodh Raja Devabhaktuni, MD; Chief Editor: Richard A Lange, MD, MBA  more...
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Individuals with cardiac syndrome X (CSX) are typically younger than those with angina due to obstructive coronary artery disease. [33]

Approximately half of patients with cardiac syndrome X have anginalike chest pain, while the remainder have atypical chest pain. The duration of anginal-type chest pain is often prolonged, [33] and it often does not respond to sublingual nitroglycerin.

Rheumatologic disorders such as fibromyalgia and costochondritis and noncardiac causes of chest pain, such as esophageal dysfunction, have occasionally been reported in patients suspected to have cardiac syndrome X. [34] Thus, a significant proportion of patients in whom cardiac syndrome X is diagnosed may have a noncardiac etiology for their chest discomfort.


Physical Examination

Abnormal physical findings that reflect ischemia, such as gallop sound and the murmur of mitral regurgitation, are uncommon in cardiac syndrome X.