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Case Report
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| Cardiac rehabilitation for cardiac syndrome X and microvascular angina: A case report | ||||||
| Wipawee Laksanakorn1, Tanaporn Laprattanagul1, Janet Wei2, Chrisandra Shufelt3, Margo Minissian4, Puja K Mehta5, C. Noel Bairey Merz6 | ||||||
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1MD, Rehabilitation Department, Golden Jubilee Medical Center, NakhonPathom, Thailand.
2MD, FACC, Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States. 3MD, MS, FACP, Associate Director, Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States. 4Ph.Dc, ACNP, FACC, Cardiology Nurse Practitioner, Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States. 5MD, FACC, Director, Non-Invasive Vascular Function Research Lab, Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States. 6MD, FACC, FAHA, Director, Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States. | ||||||
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| How to cite this article |
| Laksanakorn W, Laprattanagul T, Wei J, Shufelt C, Minissian M, Mehta PK, Merz CNB. Cardiac rehabilitation for cardiac syndrome X and microvascular angina: A case report. Int J Case Rep Images 2015;6(4):239–244. |
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Abstract
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Introduction:
Therapeutic strategies for cardiac syndrome X, characterized by the three features of angina, evidence of myocardial ischemia and no obstructive coronary artery disease, are not well known. Recent data indicate that angina secondary to microvascular coronary dysfunction is a common pathogenesis of cardiac syndrome X. While cardiac rehabilitation is well-known to be effective for angina due to obstructive coronary artery disease, less is known in cardiac syndrome X and microvascular angina patients.
Case Report: A 34-year-old female with history of pre-eclampsia during three pregnancies, recurrent non-ST-segment-elevation myocardial infarctions, no obstructive coronary artery disease, microvascular coronary dysfunction documented by coronary reactivity testing, ischemic cardiomyopathy, overweight, factor V Leiden mutation, and persistent microvascular angina was referred to cardiac rehabilitation five weeks after a non-ST-segment-elevation myocardial infarction. The patient was taking a beta blocker, ACE, statin and low dose aspirin. She underwent four sessions of supervised cardiac rehabilitation program which progressed to a duration of 45 minutes at a level of 3.3 metabolic equivalents of aerobic exercise. A normal cardiovascular response without arrhythmias was observed. A home program was suggested with moderate intensity of aerobic exercise, 30–45 minutes per day, most days of the week. She experienced decreased angina, improved quality of life and increased functional capacity at the fourth-year of follow-up. Conclusion: Cardiac rehabilitation was beneficial in the patient angina due to microvascular coronary dysfunction. Increased exercise intensity and duration, increased functional capacity, decreased anginal symptoms and improved quality of life were found. | |
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Keywords:
Cardiac rehabilitation, Cardiac syndrome X, Exercise training, Microvascular angina, Microvascular coronary dysfunction
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Author Contributions
Wipawee Laksanakorn – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Tanaporn Laprattanagul – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Janet Wei – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Chrisandra Shufelt – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Margo Minissian – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Puja K. Mehta – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published C. Noel Bairey Merz – Substantial contributions to conception and design, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 Wipawee Laksanakorn et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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