Whither thepatient with negative selective coronarography. Case report

Overview

In the case report of a female patient with a diagnosis of cardiological syndrome X, wedemonstrate an appropriate algorithm of examinations in patients with negative selectivecoronarography. It just happens that physicians in such patients frequently discontinue allmedication and consider the patient to be „in full health“. At the same time the pain andcomplaints of a patient down with syndrome Xmay be worse than in patients with demonstrableischemic heart disease.In our patient upon negative coronarography, with the aid of the hyperventilation echocardiographictest there has been ruled out vasospastic angina pectoris, and confirmed latent tetanyand a disorder in myocardial perfusion on SPECT examination. This disorder at the level ofcoronary microcirculation was most probably due to endothelial dysfunction. Diagnostic conclusion:cardiological syndrome X, latent tetany. The patient received treatment combining nitrate,calcium antagonist, acetylosalicylic acid, antidepresant, magnesium lactate. The patient remainswithout complaints under this therapy.

Key words:
cardiological syndrome X - negative selective coronarography - treatment ofsyndrome X