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Electron Beam CT in Syndrome X

Alexander Ling, MD
Author and Funding Information

Affiliations: Bethesda, MD 
 ,  Dr. Ling is a member of the Diagnostic Radiology Department National Institutes of Health Clinical Center.

Correspondence to: Alexander Ling, MD, NIH Clinical Center, Building 10, Room 1C-660, Bethesda, MD 20892; e-mail: al52x@nih.gov



Chest. 2001;120(5):1437-1439. doi:10.1378/chest.120.5.1437
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Despite the best efforts of clinicians to limit coronary angiography to symptomatic patients likely to have ischemic heart disease (coronary artery disease [CAD]), a significant minority will be discovered to have no significant vascular stenosis, occlusion, or spasm.13 Accordingly, there has been continued interest in understanding the pathophysiology of these patients and in distinguishing them from patients with CAD. The term syndrome X has been variously applied but commonly is understood to refer to patients with chest pain and ECG changes during exercise stress testing consistent with myocardial ischemia, but neither spasm nor CAD by angiography. Observed features include female predominance, pain atypical of classic angina, inconsistent response to medical therapy, and, in a subset, various hemodynamic and metabolic correlates of cardiac ischemia.

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