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Angina pectoris with normal coronary arteriograms is a common entity which has puzzled cardiologists almost since the advent of coronary arteriography. Despite major advances in the understanding of the pathophysiology of angina in recent years and a multitude of studies on the subject, the cause and mechanisms underlying the syndrome of angina with normal coronary arteries remain unknown. Indeed, results of investigations are controversial and speculation still prevails regarding the nature of the so called `Syndrome X'.
Almost every important aspect of Syndrome X has been tackled in the book and the reader is exposed not only to the cardiologists' opinion, but also to the authoritative views of the gastroenterologists, gynaecologists and psychiatrists, extremely well represented in this monograph. The book deals with `cardiologists' Syndrome X' and not the metabolic entity termed `Syndrome X'. The possible connection between the two, however, is discussed.
Angina with Normal Coronary Arteries: Syndrome X contributes to the understanding of Syndrome X and helps clinicians manage their Syndrome X-patients better and investigators to open new avenues for research.
List of contents
Chest Pain With Normal Coronary Arteriograms: Clinical Features And Prognosis.- 1. Syndrome X: A heterogeneous syndrome. Historical background, clinical presentation, electrocardiographic features, and rational patient management. An overview.- 2. Prognosis and therapy in patients with angina and normal coronary arteriograms.- 3. Chest pain with normal coronary arteriograms: Oesophageal abnormalities - The gastroenterologist's view.- 4. Chest pain with normal coronary arteries: Psychological aspects.- 5. Chest pain and angiographically normal coronary arteries in patients with systemic hypertension and left ventricular hypertrophy. Mechanisms.- 6. Syndrome X: A non-ischaemic syndrome? "False positive" ST-segment shifts, ischaemia, myocardial perfusion abnormalities and increased sensitivity to pain in syndrome.- 7. Syndrome X - An early form of cardiomyopathy?.- Syndrome X And Microvascular Angina - Abnormal Coronary Blood Flow Reserve.- 8. Microvascular angina.- 9. Studies of coronary blood flow and myocardial metabolism in patients with chest pain and angiographically normal coronary arteries.- 10. Critical view of the concept of coronary flow reserve. Advantages and disadvantages of the current methods used for the assessment of coronary flow reserve in the clinical setting.- 11. The coronary microcirculation in patients with normal coronary arteries and symptoms of chest pain - Myocardial blood flow rate, capillary permeability and interstitial diffusion.- Angina With Normal Coronary Arteriograms - Pathogenetic Hypotheses.- 12. Pre-arteriolar coronary constriction in pathogenesis of syndrome X. Role of adenosine.- 13. Abnormal neurohumoral control in pathogenesis of syndrome X.- 14. Epicardial coronary artery responses in patients with angina andnormal coronary arteriograms.- 15. Endothelial dysfunction in patients with angina and normal coronary arteriograms.- 16. Role of oestrogen deficiency in women with syndrome X.- 17. Summary, conclusions and future perspectives.- Index..
