Cardiac Syndrome X?

[KimC]

Hi,

Here's a new term I learned today: Cardiac Syndrome X which can cause microvascular spasms, i.e, chest pain.

My cardio mentioned it to me today as a possible cause for my recurring chest pain, possibly related to a problem w/ my metabolism. He prescribed nitro tablets. He doesn't think a moderate aortic leak could cause angina, and I tested negative for CAD.

1) Does anyone know anything about Cardiac Syndrome X? I found one link in the HeartCenterOnline.

2) Has anyone ever taken nitro tablets and would you mind sharing your experience?

3) Has anyone experienced chest pain prior to valve surgery and would you please include your level of regurg at the time? (I'd really like to hear from the women especially).

I'm hesitant to take any new drugs, especially given my low tolerance level. (I'm a cheap date).

Thanks,

 

[Nan]

Hi Kim, sorry to hear you are having a hard time with cardiac X syndrome (?). Sorry I have never heard of it...but I have taken nitro pills in the past for CHF.

I can't say that it is something that I liked taking as a) it burned in my mouth and b) it gave me a pretty fierce headache.

But, on the other hand it really helped with CHF, and if your cardio thinks it will help with syndrome X, perhaps it is worth a try. And, you may not have the same reaction I did.

Good Luck and let us know.

Nan

 

[Mb]

Hello!

Sorry to hear about your recent diagnosis. Go to google.com.
I found tons of links with info about this syndrome.

Marybeth

 

[Abbanabba]

Has anyone experienced chest pain prior to valve surgery and would you please include your level of regurg at the time? (I'd really like to hear from the women especially).

Hi Kim,

You didn't really say too much about what your chest pain involved, but I've noticed 2 types; one is a periodical sharp stabbing sensation behind my lower left ribs which lasts from a few moments to a minute or so. The other pain I've experienced - once when I was a teenager and again a couple of months ago - was a sensation of something really heavy on my chest between my breasts. It made it quite difficult to breathe and I was unable to sit back, or lay on my back for about 3 days because I felt like I was being "crushed" (..I eventually managed to get to sleep lying on my side leaning over almost onto my stomach (..something I will be mentioning to my cardio when I see him..)..). Don't know if that's the sort of thing you are referring to..... As far as my regurg rate, I had about a 38% back-flow in September '03, but I don't know how much that may have changed in the last 4 months.

Haven't heard of this Cardiac Syndrome X.... might have to do a Google search..(?). Have you tried boosting your magnesium intake to help with the pains? I know it helps me with restless leg syndrome...... might be worth looking into.

All the best
Anna : )

 

[Raverlaw]

Anna,

There is a lot of literature about womens' heart attack symptoms, and the "crushing" sensation you felt could definitely be the symptom of an impending or occurring mild heart attack. While there are also may other possible explanations from the pain, from heartburn on up, I strongly suggest that you get to a hospital emergency room the next time you experience this symptom. I used to be one of those who ignored aches and pains until they went away, but I know better now, and realize how lucky I am. In the future, I will be reporting any unusual event to my doctor and following his advice rather than trying to tough it out.

 

[KimC]

Anna, I agree w/ Bill ... don't be shy when it comes to your heart.

I have another friend in Australia named Anna!

Thanks everyone. The Google links were helpful.

Best,

 

[Ross]

For the sake of creating a smile, I'm posting this. I'm not saying that it's a stupid question!

 

[KimC]

ROTFL... ROTFL...

I am deleting my "Ask Jeeves" toolbar!

 

[Raverlaw]

Ross,
Thanks for the great graphic and the laugh. The graphic is now cut out and taped to the monitor of my home computer.

 

[Harpoon]

Pardon my french but, Jeeves doesn't know ****!


=Þ

 

[KimC]

Why I trusted a butler, I'll never know. Jeez.

 

[Guest]

Hi Kim!

I Found something about Syndrome X. This is from a book titled:
Women Are Not Small Men by Dr. Nieca Goldberg, Chief, Women's Heart Program, Lenox Hill Hospital.....a great book by the way...I highly recommend it to all women heart patients......
Anyway, here is some of what she has to say about Syndrome X:

"Syndrome X is a heart condition in which chest pain and ECG changes suggest narrowed arteries, yet the angiogram shows no obstructions. People with Syndrome X also have lipid abnormalities. "

"Syndrome X is much more common in women than men and is believed to result from an abnormal flexibility of the arteries. The symptoms are similar to those of angina, showing ECG abnormalities on treadmill testing, and abnornalities on a nuclear exercise electrocardiogram or and exercise echocardiogram. But the coronary angiogram shous no abnormalities, and the arteries are not obstructed by plaque."

"Once Syndrome X is diagnosed, the symptoms are treated with nitroglycerin and calcium channel blockers or beta-blockers. Once treatment is under way, the prognosis is quite good, but you should get a handle on all your rish factors and work to reduce them."

Hope this helps!

 

[Kathy]

Kim,

Prior ot MVR I had what I call an "unheartattack". We were out of town and I told my husband to take me to the nearest hospital. Nothing like scaring the wits out of your spouse.

I would describe the sensation as intense pressure from my collarbone to under my breasts. I also was very nauseated and incredibly weak. My first thought was heart attack and second thought was anxiety attack. My heart beat was very erratic and I was given medication for nausea, a seditive, and nitroglycerin. After the first dose of nitroglycerin the area of pain lessened. After the second dose the band of pain became the width of a ruler and turned sideways. It was wierd. Blood tests ruled out a heart attack but the doctors never were able to tell me what was wrong. My CCF card. said it could have been an adjustment of the valve.

All I can recall about nitro is the HEADACHE. Pain killers wouldn't touch it, but a cup of coffee helped.

 

[chilihead]

chest pain

chest pain

I had a weird pain that was on the left side of my chest prior to valve replacement. It was like an upside down crescent shape. I think it was because my heart was enlarging. No cardiologist could ever really explain it. It was the primary reason I went to my PCP initially, chest pain.

Good luck,

Jim
Ross Procedure 11/18/03

 

[KimC]

Julia,

I'm going to buy that book today. I got so mad at my cardio on Wed. when he compared me to a marathon runner who had severe AI and no symptoms. (Lucky dude). I said, "Did he also have three babies in 6 years?"

Actually, I love my cardio. He's very even-keeled. He doesn't treat me like a hysterical female, although some days I feel like one! LOL! The only thing I do NOT like about my cardio is that he reminds me of an absent-minded professor. For example, he asked me on Wed., "How does it feel to be a first-time Mom?" I looked at him very gravely, shaking my head and wondering if he even reads my medical records. He apologized ... I'm pretty easy-going with people, hell I forget things all the time, (probably the valve, right? Ha!) But I carry a whole different level of scrutiny when it comes to my HEART doc!

Kathy,

I can relate to the "band of pain" sensation. If I run up and down the stairs carrying groceries, I'll start to have chest pain and my airways tighten. I can't tell if it's my asthma causing a bronchial constriction or what my cardio suggested, a spasm. (I'm a spaz, eh?) I also feel sick to my stomach, but this could be due to the stress of feeling chest discomfort.

I haven't taken the nitro yet, but it's sitting near by. It's kinda creepy. I'm curious to see if and how it works, but not curious enough to use it unless I really, really need it. It's nice to know it's there.

Jim,

I've wondered if the discomfort is related to pressure on the left ventricle, although mine is only mildy dilated at this time. I read that the arteries leading to the aorta have many tiny capillaries that could narrow from too much pressure, hence "microvascular spasm." If my leak were more severe, maybe the larger cornorary arteries would react ... not a good thing.

So who knows. It's just another thing I'm learning to live with and accept. My PCP is alert and I'm very proactive with him about any new symptoms. He'll tell me when it's time for AVR.

Have a great weekend everyone.

 

[MarciaB]

I had chest pain and pressure for two years prior to surgery. I was told that I didn't have chest pain, or that it was anxiety (nothing like chest pain to make you anxious!). I'm a mitral valver, though, and did finally hear that 10-15% of mitral regurg patients experience chest pain. It supposedly has to do with stretching of the left atrium and pulmonary artery. The regurg was described as moderate to severe depending on who was having a bad day. It seems that regurg is very hard to measure. I haven't had any of those sensations since surgery.

Marcia

 

[hensylee]

Kim g0 to about.com, look for heart disease/cardiology (Dr Rich), go into forums and search for the X - it has been discussed there. You can also join the site, ask Dr Rich - he's a real dr; an electrophysiologist (EP) and will personally answer your questions about hearts; usually very quickly tho he sometimes goes away for the weekends.

 

[KimC]

Marcia, my doc said AI can cause chest pain, but usually not until it's severe ... he said MAYBE moderate. Good to hear that you're no longer feeling those sensations.

Hensylee, I'll try the site, thank you!

Best,

 

[KimC]

OK, so here's my problem w/ the diagnosis of CSX (from the article):

-- exercise testing, which usually reproduces the pain and shows changes on the ST segments of the ECG.

No pain was reproduced during my stress test, and no abnormal ECG, only SOB during the second to last incline.

-- cardiac catheterization, which shows normal visible coronary arteries and no inducible spasm

Haven't had a cath.

-- MRI scanning has been used in research centers to demonstrate abnormal blood flow in the heart muscle in patients with CSX after various provocative testing (such as adenosine or dobutamine infusions.) MRI scanning is not routinely done to make a diagnosis, but has offered the strongest evidence to date that patients with CSX have a true physiological abnormality associated with their chest pain.

Had this and other than the valve leaks and LV abnormality, no no ischemia during the test.

My cardio's theorizing that I have CSX based on experience, not on evidence. It takes both to make an accurate diagnosis.

I don't know what to think.

 

[fdegranville]

syndrome X

syndrome X

Hi Kim,
I can relate to the importance of your doctor being in the loop about your condition. I was seeing a dr. for four and a half years. I had been diagnosed with mitral stenosis and 3+ AI more than 20 years ago. One day when I was having an echo he asked me "How long has the aortic valve been leaking? Did you ever have rheumatic fever?" I was shocked to say the least, after 4.5 years (that probably included 6 echoes over the years all which indicated AI). I didn't want to embarass him in front of the echo tech, but I had to tell him quietly " I've always had it?" and then I realized that he had never mentioned it it, only spoke about the mitral stenosis..........I loved the guy, but knew that it was time to move on and I did.

I have had chest pain, the crushing kind during and after exertion, but is almost always involves arrhythmias too.

Hope you are feeling better with the nitro.
fdeg