Angina and normal coronary arteries in women: gynecologic findings.

Abstract

Our aim was to evaluate the hypotheses that women with severe angina and normal coronary arteries (syndrome X) have an increased incidence of hysterectomy and show a positive cardiac response to 17 beta-estradiol replacement therapy. The gynecologic histories of 30 women with syndrome X were determined. Anginal and 17 beta-estradiol insufficiency symptoms were recorded daily for 1 month. Subsequently, 20 of the women underwent hyperemic response testing before and after 2 months of estrogen replacement therapy. Hyperemic response results were compared with those of 12 asymptomatic post-menopausal women not receiving estrogen replacement therapy. Symptoms were recorded daily during estrogen replacement therapy. A total of 18 women (60%) underwent hysterectomy. All were experiencing hot flushes. Hyperemic response was diminished in women with syndrome X compared with controls. Hyperemic response increased and anginal symptoms decreased during estrogen replacement therapy. The incidence of hysterectomy was increased and estrogen replacement therapy alleviated cardiac symptoms and enhanced hyperemic response in a group of women with syndrome X.