A. “X” syndrome, women should be careful Coronary angiography is the gold standard for the diagnosis of coronary artery disease, but many patients clearly have typical symptoms of exertional angina, such as a little activity will cause discomfort in the chest and nearby areas, electrocardiogram and exercise plate test also showed positive results, but the coronary angiography shows normal. . This contradictory situation is related to the limitations of the existing diagnostic technology, because the existing cardiovascular imaging technology can only show relatively large coronary arteries, while small vessels smaller than 500 microns cannot be shown. The inconsistency between test results and symptoms may be due to microvascular abnormalities that do not appear on coronary angiograms, but do cause structural and functional abnormalities in the microcirculation, resulting in symptoms such as chest and back pain. Therefore, syndrome X is also known as “microvascular angina”. In 1973, Dr. Kemp first referred to a condition with symptoms of exertional angina and abnormal electrocardiographic changes at rest, with positive exercise tests but no coronary artery abnormalities on imaging, as syndrome X (CSX), using the “X” to emphasize its mystery. Clinically, X syndrome is more common in women, especially in postmenopausal women, and its incidence is five times higher than that of men. Second, “X” patients, a high-risk group The current clinical treatment of coronary heart disease, whether medical coronary stenting or surgical coronary artery bypass grafting are the treatment measures for the large coronary arteries, the coronary microcirculation and microvascular lesions are not enough attention. According to statistics, more than 40% of X syndrome patients have been hospitalized several times due to chest pain and become “frequent visitors” in hospitals, which seriously affects the quality of life. Compared with the normal population, patients with X have a higher incidence of cardiovascular events and are at high risk for myocardial infarction and stroke. The pathogenesis of X syndrome is not yet fully understood. It is important to recognize the disease first, and when the same conditions as above occur, it is important to suspect that you may be a patient with “X” and promptly consult a cardiovascular physician. Clinical findings show that nitroglycerin, the “panacea” for coronary artery disease and angina pectoris, is not effective for this disease. For patients with “X” syndrome, ACEI drugs (such as captopril) may be more appropriate; beta-blockers (such as atenolol) can slow down the heart rate and reduce myocardial oxygen consumption, which can also relieve symptoms. It is recommended to choose medication after diagnosis by a doctor, do not blindly use medication on your own. Some X syndrome is also related to psycho-neurological factors. Therefore, for patients under the influence of long-term anxiety, fear and other adverse emotions, psychological guidance is important, and antidepressants (such as Dextran) should be taken for treatment if necessary. V. Lifestyle is key A healthy lifestyle is a good medicine for the disease. Maintaining a lifestyle of smoking cessation, low salt and low fat diet can delay atherosclerosis. Moderate exercise can improve vascular endothelial function, which is also beneficial for patients with syndrome X.