Cardiac Syndrome X


(Image from Medscape)

Cardiac syndrome X (CSX) is anginal chest pain with coronary artery disease involving the smallest arteries, but with normal large coronary arteries. Because of this, it is sometimes referred to as “microvascular angina”. Syndrome X is difficult to diagnose; usually it is done by exclusion of other illnesses.


The most common type of angina is usually caused by a blockage in one or more coronary arteries. This causes a reduced blood supply to a part, or parts, of your heart muscle. The blockages are caused by atherosclerosis. In CSX angina is assciated with coronary arteries that appear to be normal.

  • Older patients and women with Metabolic Syndrome are more likely to diagnosed with syndrome X than other patients.
  • Common symptoms and findings include:

It is treated with beta-blockers, and usually carries a favorable prognosis.

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