Study Of The Pathophysiological Mechanisms In Patients With Typical Chest Pain and Normal Coronary Arteries

Abstract

Patients with anginal pain and normal coronary angiograms are diagnosed as cardiac syndrome- X.

They constitute about 20% of patients with chest pain who undergo coronary angiography. They have similar exercise-ECG response to coronary artery disease patients

Some have transient radioisotopic myocardial perfusion abnormalities, reduced vasodilator response m the microcirculation associated with exercise-induced regional wall motion abnormalities as well as abnormalities of diastolic function but there still some controversy on affection of left ventricular systolic function.

Pathogenesis of cardiac syndrome-X may be attributed to coronary artery disease risk factors and endothelin production, (the latter alone may lead to reduced pain threshold) both may lead to endothelial dysfunction, microvascular abnormalities and impaired myocardial perfusion.

Endothelial dysfunction, thrombogenesis and inflamation . were studied as possible mechanisms in pathogenesis of cardiac syndrome x through monitoring plasma endothelial-!, fibrinogen, VWF and CRP in patients with typical chest pain, positive stress ECG (clinical and ECG evidence of ischemia) and normal coronary angiography.