Tehran University Medical Journal

Background: All the patients with Angina pectoris have not stenotic coronary artery. Syndrome x consists of patients with Angina pectoris and positive Exercise test along with normal coronary angiography. Syndrome x includes 25-30 percent of those who undergo diagnostic coronary arteriography at the different centers. In our study it was attempted to know the prevalence and characteristics of this special group in Afshar cath-lab.

Materials and Methods: In a prospective cross sectional descriptive study 200 patients who were admitted for coronary angiography evaluated in terms of Risk factors: HTN, Family history Hyperlipidemia, DM, Cigarette smoking , clinical symptoms , response to TNG, different symptoms, ECG and Exercise test. data in two subgroups with normal and abnormal Coronary angioghraphy were compared. Six patients were excluded because of ambiguous Coronary angiography.

Results: Among 194 patients 51 patients (26.3% )had normal coronary artery. 38.9% of female and 21.4% of males showed normal coronary angioghraphy (P = 0.013). The prevalence of risk factors among those with syndrome x and abnormal coronary Artery were as follow. HTN 37% vs 42% , Hyperlipidemia 50% vs 51% , smoking 25% vs 37% , DM 12% vs 28% , obesity 45% vs 47% Positive family history for CAD = 21.5% vs 47% respectively. Angina relieved suitably with TNG in 24% of those with syndrome x compared to 76% suitable response in those with abnormal coronary arteries.(P Value = 0.49 ). Regarding to functional class , 87% of patients with normal coronary artery belonged to class I and II. also 26% had atypical pain 50% had normal rest ECG and 51% achieved stage III or IV of Bruce protocol during Exercise test.

Conclusion: Syndrome x was more prevalent among women ,also angina was less typical and less responsive to TNG. Most patients had not positive familial history for CAD. normal ECG was more prevalent among those with syndrome x .