ABSTRACT
Background: The cardiovascular syndrome X includes chest pain with positive stress test, and coronary arteries that appear normal in angiography with possible extra cardiac causes of chest pain, ruled out. The aim of the study is to evaluate the correlation between TIMI flow, contractile reserve and the coronary flow reserve in patients with cardiac syndrome X using TTDE. Methods: 60 patients with cardiac syndrome X, and 30 individuals as a control. All studied individuals were subjected to full history taking, full clinical examination, routine laboratory examination, resting ECG, treadmill stress ECG, Dobutamine stress echocardiogram and Transthoracic Doppler Echocardiogram .Results: all individuals were referred to TTDE and DSE in cardiac unit of Zagazig University Hospital from January 2017 to March 2019. The patients group showed a significant decrease in contractile reserve, a highly significant lower value of a percentage change of MAPSE with p value