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Cardiac Syndrome X or Prinzmetal's?

I am 29, thin, non-smoker/social drinker only, no drugs. Out of the blue a little over a 18 mos. ago, I began having chest pain/burning, left arm pain, left shoulder pain, upper back pain/burning, neck and jaw discomfort. Pain most days, with a week or so respite between consistant 10-14 bad days. Thought to be GERD (although PH test showed only mild acid, out of proportion with symptoms) but no response to therapy and have been assured by 2 different psychologists that my pain was not anxiety related, finally got a second opinion from a cardiologist. He thinks I have cardiac syndrome X. My concern is if it's really Prinzmetal's. Doc feels that it is not b/c my holter monitor was clear, however when I wore the monitor, I was not having a bad day. Are my symptoms consistant with Prinzmetal's or more consistant with Syndrome X? Excersise stress, echo, ECG, thallium stress all normal, never had an abnormal lab or elevated levels. What tests should I request to rule out Prinzmetal's? Much thanks.
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367994 tn?1304953593
An EKG is the only test that can dx Prinxemetal...and the vasoasm from Prinxmetal usually lasts minutes, however, unless there is an episode during the test a dx is inconclusive for a dx (as stated in your post)...

A nuclear stress test, which uses a radioactive substance that is injected into your bloodstream to show how blood flows through your arteries enabling doctors can figure out if your heart muscle is damaged or dead, or if you have a serious narrowing in an artery.

And coronary angiography, which is performed in the cardiac catheterization laboratory. Dye is injected into your bloodstream to give doctors an x-ray "movie" of heart action and blood flow through your valves and arteries (called an angiogram). Doctors can see the number of blockages that you have and how serious those blockages are.

In patients with CAD, coronary angiography usually shows a blocked artery that slows blood flow to the heart. BUT INDIVIDUALS WITH CSX, there may be an abnormal exercise stress test and a normal coronary angiogram, and the doctor may suspect cardiac syndrome X.  Because your test results are all normal the doctor concludes CSX.

There is some inconsistency with the doctor's dx showing a normal exercise stress test and reaching a CSX diagnosis with the findings I have cited?!.

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Avatar universal
I have exactly the same symptoms as you.  I have also had every test possible (except angiogram), all negative.  My cardio's have all told me that it is related to stress and to try to relax.  I have never been told about caridac X syndrome or prinzmental's eventhough I believe my symptoms fall into these categories.  I do not know of any other tests that we could have, but I just wanted to let you know that you are not alone out there.
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