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Which recommendation should I follow regarding Syndrome X?

Hello, I am a 53 year old female and have been told I have syndrome x by two different doctors.  One wants me to take high blood pressure meds and the other nitro because he thinks my blood pressure will bottom out because it runs a normal low. I do not have any pain, just uncomfortable feelings in my chest, and after extreme exercise, I need to go to bed for three days. Can you help?

submitted by Barbara from Indiana on 8/28/2012


by Texas Heart Institute cardiologist, George Younis, MD    

George Younis, MDSyndrome X refers to chest discomfort consistent with angina, but with normal coronaries [coronary arteries].  Treatment options include nitrates as well as certain medicines that are used for blood pressure, but can also cause dilation of coronary arteries, hopefully to minimize any chest discomfort.  Syndrome X is very difficult to diagnose with certainty, as there are no real established diagnostic tests to confirm its presence, although cardiac MRI may sometimes play a role. I cannot give advice in your specific case aside from saying you could try one approach, and if it doesn't work, try the other.  Both are reasonable, and sometimes a combination of both is needed.      

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Updated August 2012
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