Cardiac syndrome X is a condition in which patients have symptoms of coronary artery disease (CAD), including chest pain, but no evidence of blockages in the coronary arteries (e.g., atherosclerosis, or hardening and narrowing of the coronary arteries). Patients essentially suffer the pain of angina without CAD. The syndrome is more common in women, particularly those who are postmenopausal, and often occurs in relatively younger patients than those suffering from actual CAD.

There are a number of diagnostic tests that can help determine if an individual’s chest pain is due to cardiac syndrome X or CAD. These tests include an electrocardiogram (EKG), echocardiogram, stress test and coronary angiography. These tests can assess blood flow through the arteries and heart function to check for other possible causes of chest pain.

Treatment for cardiac syndrome X is aimed towards relieving chest pain. Patients may be prescribed cardiac medications such as nitrates, beta-blockers or channel blockers.

A number of possible causes have been proposed, but further research is necessary to understand the syndrome more completely. Possible causes include lack of blood flow to the heart (ischemia), hormone deficiencies and autonomic system imbalance.

Although the condition can affect patients physically and emotionally, cardiac syndrome X does not cause damage to the heart muscle and is not life-threatening.