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European Heart Journal 2004 25(19):1672-1674; doi:10.1016/j.ehj.2004.06.008
Copyright © 2004 by the European Society of Cardiology.
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Editorial

Hearts and minds: psychological factors and the chest pain of cardiac syndrome X

Stuart D. Rosen*

Department of Clinical Cardiology, Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, UK

* Correspondence to: Stuart D. Rosen, MD, Department of Cardiology, Ealing Hospital, Uxbridge Road, Middlesex UB1 3HW, UK. Tel.: +44-208-967-5359; fax: +44-208-967-5007
stuart.rosen@imperial.ac.uk

The first 150 words of the full text of this article appear below.

This editorial refers to "Distinct psychosocial differences between women with coronary heart disease and cardiac syndrome X"1 by E.A. Asbury et al. on page 1695

The pathophysiology of cardiac syndrome X (CSX, anginal pain and ischaemic-like stress ECG despite angiographically normal coronary arteries) has evolved from a paradigm centred around myocardial ischaemia, via the conceptual bridge of abnormal autonomic neural regulation of the heart, to one based upon neurophysiological differences affecting pain perception.1 The direction of therapeutic strategies has moved in parallel. This development of thinking has brought with it an increased interest in psychological factors.

Psychological factors in CSX

In the present issue of the European Heart Journal, Asbury et al., report an extensive study of psychosocial factors and the ill health of women with CSX, as compared to women with known coronary artery disease (CAD) and normal controls.2 The definition of CSX was strict and included `angiographically smooth coronary arteries'. Asbury . . . [Full Text of this Article]

Historical context

Follow-up studies on morbidity in CSX

The oestrogen hypothesis


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Related articles in EHJ:

Distinct psychosocial differences between women with coronary heart disease and cardiac syndrome X
Elizabeth A. Asbury, Francis Creed, and Peter Collins
EHJ 2004 25: 1695-1701. [Abstract] [Full Text]  



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