Cardiac rehabilitation for cardiac syndrome X and microvascular angina: A case report

Wipawee Laksanakorn ； Tanaporn Laprattanagul ； Janet Wei ； Chrisandra Shufelt ； Margo Minissian ； Puja K. Mehta ； C. Noel Bairey Merz

《International Journal of Case Reports and Images (IJCRI)》 6卷4期 (2015/04) Pp. 239-244+xi

https://doi.org/10.5348/ijcri-201542-CR-10503

並列摘要

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.

並列關鍵字

Cardiac rehabilitation ； Cardiac syndrome X ； Exercise training ； Microvascular angina ； Microvascular coronary dysfunction