2016


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2016/№5

Primary microvascular angina (cardiac syndrome X): Clinical manifestations, prognosis, diagnosis, and treatment

Boldueva S. A., Leonova I. A.
State Budgetary Educational Institution of Higher Professional Education, "I. I. Mechnikov North-West State Medical University" of the RF Ministry of Health Care, Kirochnaya 41, St.‑Petersburg 191015

Keywords: cardiac syndrome X, microvascular angina, prognosis, diagnostics

DOI: 10.18087/rhj.2016.5.2199

In recent decades, coronary angiography (CAG) has become a «gold standard» for examination of IHD patients in Russia. While this method provides solutions for many diagnostic and tactic problems it also often raises new questions for physicians. Such questions are particularly related with situations when patients with chest pain and signs of ischemia observed during stress tests have unchanged coronary arteries (UCA). It should be noted that such problem is not infrequent; according to different reports 10–20 % of men and 30–50 % of women have non-obstructive coronary disease on CAG. For such patients, the case may be primary microvascular angina (PMVA) or cardiac syndrome X (CSX), which is another term for the same condition. Despite more than 40‑year history of studies, there are still many unsolved issues in diagnosis, prognosis and treatment of PMVA. This review discusses existing diagnostic methods, provides an algorithm for patient examination, which can be used in everyday clinical practice, and focuses on different points of view about prognosis and treatment of this disease. Key words: cardiac syndrome X, microvascular angina prognosis, diagnosis and treatment.
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