What do you understand by the term 'syndrome X' ? • Syndrome X , or microvascular angina , is the presence of classic angina and ST depression on exercise stress testing and a normal coronary angiogram in the absence of any other demonstrable cardiac abnormalities. • Reaven's syndrome or 'endocrine' syndrome X is the association of insulin resistance, hypertension,and increased very low density lipoprotein (VLDL) and decreased high density lipoprotein (HDL) cholesterol concentrations in the plasma. Coronary artery bypass grafting wasintroduced by R.G. Favalaro in 1969 while he was at the Cleveland Clinic, USA (J Thorac Cardiovasc Surg 1969; 58: 178-85). Balloon angioplasty was introduced by Arthur Gruntzig, a Swiss cardiologist, in 1977 (Lancet 1978; i: 263).
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