Unstable angina / non ST elevation myocardial infarction cardiovascular syndrome x

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Overview of Cardiovascular Syndrome X in UA / NSTEMI

ACC / AHA Guidelines (DO NOT EDIT) [1]

Class I

1. Medical therapy with nitrates, beta blockers, and calcium channel blockers, alone or in combination is recommended in patients with cardiovascular syndrome X. (Level of Evidence: B)

2. Risk factor reduction is recommended in patients with cardiovascular syndrome X. (Level of Evidence: B)

Class IIb

1. Intracoronary ultrasound to assess the extent of atherosclerosis and rule out missed obstructive lesions may be considered in patients with syndrome X. (Level of Evidence: B)

2. If no ECGs during chest pain are available and coronary spasm cannot be ruled out, coronary angiography and provocative testing with acetylcholine, adenosine, or methacholine and 24 h ambulatory ECG may be considered. (Level of Evidence: C)

3. If coronary angiography is performed and does not reveal a cause of chest discomfort, and if syndrome X is suspected, invasive physiological assessment (i.e., coronary flow reserve measurement) may be considered. (Level of Evidence: C)

4. Imipramine or aminophylline may be considered in patients with syndrome X for continued pain despite implementation of Class I measures. (Level of Evidence: C)

5. Transcutaneous electrical nerve stimulation and spinal cord stimulation for continued pain despite the implementation of Class I measures may be considered for patients with syndrome X. (Level of Evidence: B)

Class III

1. Medical therapy with nitrates, beta blockers, and calcium channel blockers for patients with non cardiac chest pain is not recommended. (Level of Evidence: C)

See Also

Sources

  • The ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction [1]

References

  1. 1.0 1.1 Anderson JL, Adams CD, Antman EM; et al. (2007). "ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine". JACC. 50 (7): e1–e157. PMID 17692738. Text "doi:10.1016/j.jacc.2007.02.013 " ignored (help); Unknown parameter |month= ignored (help)

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