Syndrome X: an uncommon cause of angina

A 61-year old lady presented clinically in unstable angina with ST-segment depression typical of myocardial ischemia. However, coronary arteries were completely normal at angiography. Exercise testing reproduced symptoms and ST-segment depression. A diagnosis of Syndrome X was made, an uncommon disorder of myocardial ischemia with normal coronary anatomy and excellent prognosis.