Coronary artery anomalies in patients with syndrome X

Abstract

Cardiac syndrome X (CSX) is characterized by typical angina, abnormal exercise test results, and no critical coronary stenosis (1). Coronary artery anomalies (CAAs) are a group of congenital disorders resulting in a highly variable clinical phenotype (2). There is a growing interest in the incidence of these anomalies and in their role in the manifestations of ischemic heart disease (3). To our knowledge, however, the role of structural cardiovascular abnormalities in the pathogenesis of syndrome X remains unclear. In the present study, we sought to investigate the presence and frequency of CAAs in patients with CSX. We reviewed the records of 50 patients with CSX who had undergone exercise electrocardiogram test and coronary angiography at the Uluda¤ University Cardiovascular Laboratories between 2003 and 2005. The following variables were collected: time of 1-mm ST depression, onset of angina, maximum ST segment shift, number of leads (derivations) with ST depression observed at peak exercise, and exercise duration in multiples of resting O2 consumption (METS). All patients underwent coronary angiography using the standard Judkins technique.