What Is the Treatment for Syndrome W?

Statistics have found that 15% to 45% of patients diagnosed with coronary heart disease without coronary angiography are actually syndrome X. The ECG showed changes in myocardial ischemia at the onset of the disease or after a non-invasive cardiac load (such as exercise plate tests). Coronary angiography did not reveal vessel stenosis or obstruction. However, it can be seen clinically that many patients do not have the above-mentioned manifestations of myocardial ischemia, thereby increasing the difficulty of clinical diagnosis. Therefore, isotope myocardial perfusion imaging has recently become more important in the diagnosis of syndrome X, and it is playing an increasingly important role. Patients should cooperate with doctors for examination and treatment as soon as possible, and strive for early recovery.

X Syndrome

Heart X syndrome is a relatively new name for most patients. The clinical diagnosis is based on recurrent chest tightness, chest pain, coronary angiography or coronary CT, and positive exercise plate test. At present, it is widely accepted by clinicians because the vascular dysfunction of the coronary arteries causes myocardial ischemia, so it is named "microvascular angina pectoris". From this, we can think that patients with cardiac X syndrome mainly show recurrent chest pain, which can occur after exertion, or can occur during a quiet rest. Chest pain can last for a few seconds or up to several hours, and Female patients are more common, especially after menopause.

X Syndrome Introduction

Statistics have found that 15% to 45% of patients diagnosed with coronary heart disease without coronary angiography are actually syndrome X. The ECG showed changes in myocardial ischemia when the disease occurred or after a non-invasive cardiac load (such as exercise plate test). Coronary angiography did not reveal vessel stenosis or obstruction. However, it can be seen clinically that many patients do not have the above-mentioned manifestations of myocardial ischemia, thereby increasing the difficulty of clinical diagnosis. Therefore, isotope myocardial perfusion imaging has recently become more important in the diagnosis of syndrome X, and it is playing an increasingly important role. Patients should cooperate with doctors for examination and treatment as soon as possible, and strive for early recovery.

X What is X syndrome?

The so-called "X" syndrome refers to those who have typical symptoms of exertional angina pectoris or positive electrocardiogram exercise test, normal coronary angiography, and need to exclude those with coronary spasm. "Syndrome X" is also called "microvascular angina pectoris", and its possible pathogenesis is caused by abnormalities in the structure and function of the microvasculature of the coronary arteries smaller than 200 microns and its microcirculation. In the process of understanding and diagnosing the above-mentioned concepts, we must avoid guessing, subjective reasoning, and partial generalizations; we should focus on objective evidence and comprehensive evaluation; strict diagnosis and lenient treatment. That is, don't easily put on a "coronary heart disease" hat without sufficient evidence, and use appropriate preventive treatment to reduce risk.

X Factors Affecting Cardiac X Syndrome

So what is the role of isotope myocardial imaging in the diagnosis of cardiac X syndrome? Practice has found that isotope myocardial imaging can be used to understand the filling of the heart's blood vessels, so as to determine whether there is myocardial ischemia or even myocardial infarction, and to understand the reserve function of myocardial blood flow perfusion, and then the load or challenge test can identify whether it is a crown Vein macrovascular disease is the presence or absence of coronary heart disease, as well as the presence of cardiac microvascular disease. Delayed imaging can also understand the survival status and functional status of myocardial cells. It can be seen that isotope myocardial imaging has a very important role and significance in the diagnosis of various cardiac blood vessels, microvascular diseases such as coronary heart disease, syndrome X, and myocarditis, as well as the evaluation of cardiomyocyte damage and the evaluation of cardiomyocyte function. Moreover, by comparing the results of isotope myocardial imaging before and after treatment, the effect of treatment can also be judged and evaluated, which can prompt the prognosis of related heart diseases.

Some people are worried about whether isotope myocardial imaging will cause complications and damage physical health? As we all know, isotope is a radioactive substance, and two isotope myocardial imaging examinations are required during the diagnosis and treatment of cardiac microvascular disease. Many patients have great concerns about isotope physical harm, for fear of causing cancer or producing other Disease, and therefore unwilling to accept the test, this has affected the diagnosis of the disease and the judgment of the curative effect after treatment and the estimation of the prognosis to a certain extent. As everyone knows, the isotope dose used by the hospital is the lowest dose that can meet the imaging requirements, and it is a safe dose that does not affect physical health. Moderate isotope examination will not cause damage to the body, and patients need not worry about it.

X X Syndrome X Syndrome Treatment

1. The purpose of treatment is to first eliminate the patient's doubts, and then quickly relieve the symptoms. It is common for the symptoms to persist. Therefore, many patients cannot return to work. CAG shows that the coronary artery itself can eliminate the patient's doubts. In one study, when patients learned that the coronary arteries were normal, they both reduced the number of hospital stays and shortened the number of hospital stays due to cardiac causes.

2. Treatment No special treatment for Syndrome X.

Commonly used anti-angina drugs such as nitrates, calcium antagonists and beta-blockers can be used for the treatment of this disease, but the effect is not constant. Symptoms may be reduced or relieved in some patients, but may not be significant in others. Both beta blockers and calcium antagonists are effective in reducing the number of chest discomforts, and the beneficial effects of nitrates have been found in only half of patients. In patients with X syndrome, sublingual nitrate can not improve exercise tolerance, and some patients may reduce exercise tolerance; and calcium antagonists can reduce the frequency and severity of angina pectoris in some patients, and increase exercise tolerance. Body blockers are less effective than those used for coronary heart disease and labor angina pectoris, suggesting that reducing myocardial oxygen demand is not an effective measure to prevent or compensate for abnormal vascular movement.

The use of alpha adrenergic blockers seems to be a reasonable treatment, but the results of small-scale trials are still inconsistent; the antidepressant imipramine (50mg / d) can effectively reduce the frequency of chest pain by 50% and menopause Later women's application of hormone replacement therapy can reduce the effect of normal coronary arteries on acetylcholine, increase coronary blood flow, and improve endothelial-dependent coronary dilation. One study proved that this hormone can reduce the frequency of chest pain by 50%.

Therefore, first explain to the patient that the mid-term prognosis of the disease is quite good, remove their concerns, and then treat with long-acting nitrate. If the patient still has symptoms, calcium antagonists or beta-blockers should be started, and imipramine 50mg / d can be used finally. If symptoms persist after treatment with the above drugs, other causes of chest pain should be ruled out, especially abnormal esophageal movement.

The mid-term prognosis is very good. The CASS registry reported a 7-year survival rate of 96% in patients with angina pectoris, normal coronary angiography, and LVEF> 0.50, while those with CAG showing mild abnormal lumen stenosis <50% had a 7-year survival rate of 92%. Even if these patients have a history of smoking or hypertension, exercise-induced myocardial ischemia does not increase mortality, so their prognosis is good.

The long-term survival rate of patients with angina pectoris but normal CAG is very high, which is significantly higher than that of patients with coronary stenosis, and there is no difference between the survival rate of normal people of the same age. Nonetheless, long-term follow-up visits have often shown that left ventricular function remains normal, but many patients have chest pain and require medication.

X X syndrome X syndrome should pay attention to the diet

1. Eat more foods rich in vitamins and dietary fiber. Such as fresh vegetables, fruits, whole grains, etc .;

Should eat Xin Wen Xuanhua, ventilation and blood products, such as onions, garlic, parsley, almond cream, carrots, jujube, leek, wine and so on.

2. What is not suitable for eating?

Try to avoid irritating and flatulent foods, such as strong tea, coffee, pepper, curry, etc .;

Avoid fatty foods such as fatty meat and seafood. ?

X Syndrome related reading

Although most people think that the clinical prognosis of cardiac X syndrome is good, but it will affect the heart function in the long run. At the same time, a few scholars believe that if these patients are not treated in time, they may develop into coronary heart disease, myocardial infarction or cerebral blood vessels (stroke). ). Moreover, recurrent episodes of pain in the precardiac area will significantly affect the quality of life, increase the psychological burden and the financial burden of repeated medical treatment, and affect the quality of life and work.

At present, the treatment of heart syndrome X is only used for the treatment of coronary heart disease, and its effect is not good. Therefore, the doctors of the emergency department of Shanghai Chest Hospital started to improve the cardiac microcirculation and used the combination of traditional Chinese and western medicine to treat the heart syndrome X. The effect was significant. A considerable number of patients had clinical symptoms, exercise tests, and radionuclides after treatment. Inspections have all made significant improvements. Therefore, it is recommended that patients with similar symptoms or those who have been diagnosed with cardiac X syndrome can receive early examination and treatment, and do not delay medical treatment by blindly seeking medical treatment.