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KMID : 0368119920220010166
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Korean Circulation Journal
1992 Volume.22 No. 1 p.166 ~ p.172
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A Case of Syndrome X.
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박태병
고광곤/김슨혜/조철호/조상균/김삼수/박승우
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Abstract
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Typically, patients afflicted with syndrome X complained of stress induced angina pectoris. and their electrocardiograms show corresponding ST-segment depressions during exercise. However. angiography is unable to demonstrate significant coronary
artery
luminal narrowing and significant coronary artery spasm to provocation test. And left ventricular performance at rest remains remarkably unimpaired. Syndrome X s characterized by reduction of cornary vascular reserve but without depression of
left
ventricular performance or negative effect on survival. The reduction of coronary vascular response is supposed to be resulted from reduced coronary vasodilator response due to abnormal contraction of coronary prearteriolar vessels.
This case is a 43-year-old female who has had exertional chest pain since 5 months ago. The chest pain was relieved by rest and subligual nitroglycerin administration. The exercise electrocardiography showed significant ST segment depressions on
lead
II. III, aVF and V4-V6 at stage 1, when she experienced chest pain. On 24 hour ambulatory electrocardiogram. significant ST segment depression was recorded at the time when the patient had chest pain. But coronary arteriography demonstrated
normal
coronary artery and no significant coronary artery spasm to provocation test with ergonovine maleate. On exercise thallium-201 scintigraphy, perfusion decrease was suspected on anterolateral wall of left ventricle. The patient was diagnosed as a
syndrome X and was managed with isosorbide and nifedipine and her exercise tolerance increased significantly on follow up exercise test performed 1 month later. But she has complained of a few of attack of chest pain until now.
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KEYWORD
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