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Cardiac syndrome X: a critical overview and future perspectives
  1. G A Lanza
  1. Correspondence to:
    Dr Gaetano A Lanza
    Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Largo A Gemelli, 8, 00168 Rome, Italy; g.a.lanza{at}


The classic definition of cardiac syndrome X (CSX) seems inadequate both for clinical and research purposes and should be replaced with one aimed at including a sufficiently homogeneous group of patients with the common plausible pathophysiological mechanism of coronary microvascular dysfunction. More specifically, CSX should be defined as a form of stable effort angina, which, according to careful diagnostic investigation, can reasonably be attributed to abnormalities in the coronary microvascular circulation.

  • CAD, coronary artery disease
  • CBF, coronary blood flow
  • CSX, cardiac syndrome X
  • LV, left ventricular
  • MIBG, metaiodobenzylguanidine
  • MR, magnetic resonance
  • PET, positron emission tomography

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  • Published Online First 6 January 2006