(LifeWire) - Chest pain and numbness in your arms while exercising may lead you to fear a heart attack.
Your doctor's first thought may be angina pectoris -- pain caused by muscles starved for oxygen-rich blood.
But it may also be microvascular angina, sometimes called Cardiac Syndrome X (CSX).
The symptoms are:
- a painful sense of squeezing or vice-like pain in the middle of the chest
- aching or burning in the chest
- pain outside the chest
- discomfort in the jaw, neck, shoulders or arms
- shortness of breath, excess perspiration, nausea, light-headedness
Exercise stress test results look the same whether you have CSX or angina. But angina is caused by atherosclerosis, "hardening of the arteries," and so it is common in people who have coronary artery disease (CAD).
But people with CSX don't have CAD. The pain of CSX is caused by contractions in tiny blood vessels -- capillaries -- in the heart. Less blood flows to (and from) the heart as a result -- causing the pain and other symptoms. But because capillaries are small, this tightening doesn't make a heart attack more likely.
Coronary angiography -- an x-ray in which details of the heart are shown with the help of the injection of a special dye -- diagnoses CSX by ruling out angina. If no blocked blood vessels are seen, the problem isn't angina. The tiny capillaries affected by CSX are too small to show up in this test.
We don't know why the capillaries constrict in this condition. We do know women get CSX more often than men and that it is not a serious condition.
CSX is usually treated with medications that reduce the pain, that is, nitroglycerin drugs, such as Nitro-Bid, beta blockers, including Lopressor (metoprolol), and calcium channel blockers, like Norvasc (amlodipine).
A newer treatment, enhanced external counterpulsation (EECP) increases blood supply to the arteries using inflatable cuffs on the patient's legs.
Read more about cardiac syndrome x here.
Sources:
"Angina." texasheart.org. Aug. 2008. Texas Heart Institute. 21 Nov. 2008 <http://www.texasheart.org/HIC/Topics/Cond/Angina.cfm>.
"Cardiac Syndrome X." texasheart.org. Aug. 2008. Texas Heart Institute. 18 Nov. 2008 <http://www.texasheartinstitute.org/HIC/Topics/Cond/CardiacSyndromeX.cfm>.
"Conditions: Angina." dartmouth.edu. 2006. Dartmouth University. 21 Nov. 2008 <http://www.dartmouth.edu/~cardio/Patients/conditions/con_angina.html>.
"EECP for Patients." stjohn.org. 2008. St. John Hospital. 21 Nov. 2008 <http://www.stjohn.org/EECP/Patients/works/>.
Kronhaus, Kenneth, D., and William E. Lawson. "Enhanced external counterpulsation is an effective treatment for Syndrome X." International Journal of Cardiology online(2008). 18 Nov. 2008 <http://www.internationaljournalofcardiology.com/article/S0167-5273(08)00488-9/abstract>. (subscription)
