Copyright © 1995 by the European Society of Cardiology.
© 1995 The European Society of Cardiology
Syndrome X in women is associated with oestrogen deficiency
Department of Cardiac Medicine, National Heart & Lung Institute and Royal Brompton Hospital London, U.K.
*St Georges Hospital London, U.K.
revised 17 August 1994; accepted 5 September 1994.
Correspondence: G.M.C. Rosano, Department of Cardiac Medicine, National Heart & Lung Institute, Dovehouse Street, London SW3 6LY. U.K.
Abstract
This study was undertaken to ascertain whether gynaecological history or a reduction in ovarian hormones are triggers of angina in menopausal women with a positive exercise test and normal coronary arteries. The majority of patients with angina pectoris, a positive exercise test and normal coronary arteries are female, suggesting that the female gender may be important in the aetiology. We studied the gynaecological features of 107 women (age 53 ±9 years) with syndrome X, taken from a population of 134 patients including 27 males. Cardiological investigations were undertaken and detailed gynaecological history obtained from all the female patients. Menopausal status was confirmed by plasma levels of oestradiol-17ß
100 pmol. l–1.
In 95 of the 107 female patients, chest pain began either during the perimenopausal period (32) or after the menopause (63). Of the 63 menopausal patients, 43 had undergone hysterectomy at an average of 8 ± 6 years prior to the onset of chest pain. The incidence of hysterectomy in the study population (40%) was four times greater than that of an age-matched population. These findings confirm that the majority of patients with syndrome X are women in whom the chest pain began after the onset of menopause. Ovarian hormone deficiency may, therefore, play a role in the onset of syndrome X in female patients.
Key Words: Angina • oestrogen • exercise test • hormones • coronary arteries • syndrome X
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