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Cardiac Syndrome X after CABGx3
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Cardiac Syndrome X after CABGx3

I had triple-bypass surgery 15 months ago, followed by pericarial window surgery a couple of weeks later to relieve fluid buildup after the CABG surgery. A few months after the surgery I began going to cardiac rehab and, over a three-month period, was able to exercise moderately (walking and biking) for 45-60 mins 4 to 5 days a week with absolutely no chest pain. Then, about 6 mos ago I started having knee problems and visited an orthopedic doctor who gave me a shot of cortisone and told me to rest my knee (which I did for a period of about three months). I then began walking again, but this time I noticed that after about 10 minutes or so I developed chest pain (nothing major, but definitely not pain free the way I had been before my knee started hurting). I wasn't able to walk as much as I had before for a variety of reasons, but noticed about a month ago that I was unable to go more than 5 minutes without developing considerable chest pain. I contacted my cardiologist and had a nuclear stress test done, which showed that the front area of my heart was not getting enough blood flow. The Dr was pretty sure that at least one of my grafts had started blocking up and indicated that it was not uncommon for that to happen, but was fairly rare for it to happen after just over a year. He ordered an angiogram and indicated that he'd probably end up putting a stent in whatever graft was blocked. Fast-forward to angiogram: He was shocked to find that all three of the grafts were in perfect shape (completely open and flowing). When I went back for a follow-up visit, he indicated that he didn't know why I had chest pain and prescribed Imdur and regular nitro pills (telling me to take the Imdur daily and the nitro as needed). He indicated that I might have what's called Cardiac Syndrome X and said that, while it resulted in chest pain (sometimes severe) it wasn't really life threatening and I could go ahead and exercise (taking nitro as needed). The question I have, that he could not answer, is how could this just pop up all of a sudden when I didn't have it for the first few months after my CABG surgery? Anyone else diagnosed with this after bypass surgery? What to do? Very frustrated at this point.
Avatar_dr_f_tn
Hello and hope you are doing well.

Understand your predicament.
Cardiac syndrome X  is described as microvascular angina, where the smaller vessels are affected and the cause is usually not known. According to studies done, patients with CSX have excellent long-term clinical prognosis. During follow-up, chest pain had remained unchanged in 33% of patients and had worsened in 14% of patients. A significant number of patients, however, shows persistence or worsening of symptoms, as well as further recurrence to medical evaluation.

Hope this helped and do keep us posted.
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