Also known as “soldier’s heart” or “cardiac neurosis,” Da Costa syndrome was first described during the American Civil War when soldier’s would have typical anginal symptoms, however autopsy would reveal normal coronary arteries. This was thought to be related to the stress of war as first described by Dr. Jacob Da Costa at that time.

Symptoms are that of typical angina, however no abnormality is detected on stress testing or angiography and typical anginal therapies are not effective. In modern times, Da Costa’s syndrome is considered part of a generalized anxiety disorder and similar symptoms are sometimes seen as a part of the mitral valve prolapse syndrome. This is somewhat different than syndrome X which can indeed show signs of myocardial ischemia despite normal coronary arteries and no inducible coronary vasospasm.