Cardiac Syndrome X Treatment & Management

Updated: Dec 18, 2014
  • Author: Subodh Raja Devabhaktuni, MD; Chief Editor: Richard A Lange, MD, MBA  more...
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Medical Care

Cardiac syndrome X (CSX) is treated with lifestyle modification, [1] including diet, exercise, smoking cessation, and weight reduction. A cardiac-prudent diet is advised.

Pharmacotherapy may involve the use of anti-anginal, anti-atherosclerotic, and anti-ischemic agents. [1]

Spinal cord stimulation: Spinal cord stimulation led to a significant reduction in chest pain and improved quality of life in about 50% of patients resistant to all other treatment. [35]

Psychological therapy: Cognitive behavioral therapy and group therapy have shown promising results in reducing episodes of chest discomfort over a period of 3-6 months. [36, 37] They are more effective if started early.

Physical training: A physical training program may improve exercise capacity and reduce the frequency of chest pain episodes. [38]

Enhanced external counter pulsation (EECP): EECP may reduce symptoms through an improvement in endothelial function, promotion of collateralization, ventricular function enhancement, and peripheral effects resembling those seen with regular physical exercise. [39] Bonetti et al reported successful treatment of CSX with severely symptomatic coronary endothelial dysfunction in the absence of obstructive coronary artery disease with standard 35-hour course of EECP therapy. [40]

Neurostimulation and stellate ganglionectomy may be alternative treatment options. [1]