Cardiac rehabilitation for the treatment of women with chest pain and normal coronary arteries

Objective: To explore cardiac rehabilitation (CR) as a treatment for psychological and physiological morbidity in women with chest pain and normal coronary arteries (cardiac syndrome X). Design: Sixty-four women aged 57.3 ± 8.6 years (mean ± SD) with cardiac syndrome X were randomly assigned to an 8-week phase III CR exercise program or symptom monitoring control. All women completed the Hospital Anxiety and Depression Scale, Health Anxiety Questionnaire, and Short Form-36 before and after intervention and at the 8-week follow-up. CR patients underwent physical assessment before and after CR. Results: After CR, patients demonstrated improved symptom severity (2.0 ± 0.8 vs 1.26 ± 1.1, P = 0.009), Hospital Anxiety and Depression Scale depression score (8.0 ± 3.4 vs 6.4 ± 3.1, P = 0.04), total Health Anxiety Questionnaire score (12.0 ± 5.5 vs 9.5 ± 6.0, P = 0.008), health worry (4.5 ± 3.1 vs 3.52 ± 2.4, P = 0.025) and interference (2.4 ± 1.8 vs 1.6 ± 1.8, P = 0.004), SF-36 physical functioning (53.1 ± 20.4 vs 62.3 ± 23.9, P = 0.006), energy (36.3 ± 20.7 vs 49.8 ± 19.1, P < 0.001), pain (49.9 ± 20.7 vs 58.1 ± 22.9, P = 0.028), and general health (48.8 ± 17.9 vs 57.6 ± 17.0, P = 0.01) not found among the control women. Improvements were maintained at follow-up. CR patients showed significant improvements in Shuttle Walk Test performance (326.8 ± 111.0 vs 423.6 ± 133.2 m, P < 0.001), diastolic blood pressure (84.7 ± 9.4 vs 79.7 ± 7.3 mm Hg, P = 0.007), and body mass index (29.1 ± 6.0 vs 28.4 ± 6.17 kg/m2, P = 0.003). Conclusions: An 8-week phase III CR program improves exercise tolerance, quality of life, psychological morbidity, symptom severity, and cardiovascular risk factors in women with cardiac syndrome X.