OBJECTIVES: Our aim was to evaluate the hypotheses that women with severe angina and normal coronary arteries (syndrome X) have an increased incidence of hysterectomy and show a positive cardiac response to 17 beta-estradiol replacement therapy. STUDY DESIGN: The gynecologic histories of 30 women with syndrome X were determined. Anginal and 17 beta-estradiol insufficiency symptoms were recorded daily for 1 month. Subsequently, 20 of the women underwent hyperemic response testing before and after 2 months of estrogen replacement therapy. Hyperemic response results were compared with those of 12 asymptomatic post-menopausal women not receiving estrogen replacement therapy. Symptoms were recorded daily during estrogen replacement therapy. RESULTS: A total of 18 women (60%) underwent hysterectomy. All were experiencing hot flushes. Hyperemic response was diminished in women with syndrome X compared with controls. Hyperemic response increased and anginal symptoms decreased during estrogen replacement therapy. CONCLUSION: The incidence of hysterectomy was increased and estrogen replacement therapy alleviated cardiac symptoms and enhanced hyperemic response in a group of women with syndrome X.
OBJECTIVES: Our aim was to evaluate the hypotheses that women with severe angina and normal coronary arteries (syndrome X) have an increased incidence of hysterectomy and show a positive cardiac response to 17 beta-estradiol replacement therapy. STUDY DESIGN: The gynecologic histories of 30 women with syndrome X were determined. Anginal and 17 beta-estradiolinsufficiency symptoms were recorded daily for 1 month. Subsequently, 20 of the women underwent hyperemic response testing before and after 2 months of estrogen replacement therapy. Hyperemic response results were compared with those of 12 asymptomatic post-menopausal women not receiving estrogen replacement therapy. Symptoms were recorded daily during estrogen replacement therapy. RESULTS: A total of 18 women (60%) underwent hysterectomy. All were experiencing hot flushes. Hyperemic response was diminished in women with syndrome X compared with controls. Hyperemic response increased and anginal symptoms decreased during estrogen replacement therapy. CONCLUSION: The incidence of hysterectomy was increased and estrogen replacement therapy alleviated cardiac symptoms and enhanced hyperemic response in a group of women with syndrome X.