Chest pain without coronary artery narrowing - Syndrome X / Microvascular Angina

Angina is the name which doctors give chest pain which arises from inadequate blood supply to the heart usually when it occurs we find narrowing in the coronary arteries however this is not always the case.

Why might that be? First it is possible that the patient does have significant coronary disease but it has been underestimated at the time of the angiogram. Second it is possible that the patient's symptoms are not that of angina. However we not uncommonly see a situation where the patient is describing angina, there are changes on the ECG either during chest pain or at the time of exercise ECG and the coronary arteries appear to be normal at the time of angiogram. When this occurs we say the patient has cardiac syndrome X also known as microvascular angina. Some patients may have coronary spasm which is different from microvascular angina.

Useful Links:
Women, Cardiac Syndrome X and Microvascular Angina
Persistent cardiac pain resource centre