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Canadian Journal of Cardiology

Cardiac Syndrome X: Mystery Continues

      Cardiac syndrome X (CSX) continues to be a mystery for clinicians who see patients with symptoms suggestive of obstructive coronary disease but who in fact lack evidence of coronary obstruction. Mysterious, this syndrome also stands out by the fact that it appears to preferentially affect women. In this supplement issue of the Canadian Journal of Cardiology (CJC) focused on persistent cardiac pain, CSX rightly deserves discussion by Arthur et al.,
      • Arthur H.M.
      • Campbell P.
      • Harvey P.J.
      • et al.
      Women, cardiac syndrome X, and microvascular heart disease.
      alongside other outstanding topics in cardiology, such as mechanisms of cardiac pain (Rosen
      • Rosen S.D.
      From heart to brain: the genesis and processing of cardiac pain.
      ), classification of nonrevascularizable patients (Jolicoeur et al.
      • Jolicoeur E.M.
      • Cartier R.
      • Henry T.D.
      • et al.
      Patients with coronary artery disease unsuitable for revascularization: definition, general principles, and a classification.
      ), refractory angina management (McGillion et al.
      • McGillion M.
      • Arthur H.M.
      • Cook A.
      • et al.
      Management of patients with refractory angina: Canadian Cardiovascular Society/Canadian Pain Society joint guidelines.
      ), and the continued problem, impact, and management of stable angina (Parker
      • Parker J.D.
      • Parker J.O.
      Stable angina pectoris: the medical management of symptomatic myocardial ischemia.
      ). While Arthur et al.
      • Arthur H.M.
      • Campbell P.
      • Harvey P.J.
      • et al.
      Women, cardiac syndrome X, and microvascular heart disease.
      provide a comprehensive coverage of the current state of our knowledge of CSX, we, in this editorial, would like to emphasize some of the points raised regarding CSX in the hope of helping to demystify this syndrome and provide a useful roadmap for the future.
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