Cardiac syndrome is a varied condition, both clinically and pathophysiologically, including several pathogenic pathways. The management of this illness poses a significant challenge to the treating physician. Patients frequently want medical attention due to persistent and debilitating chest discomfort, sometimes necessitating recurrent and expensive invasive and non-invasive evaluations. Thoroughly examining the patient to find underlying pathophysiological mechanisms and ruling out other possible causes of chest pain, along with taking into account psychosocial factors, can help reduce the stress and distress these people are feeling. This article examines the existing research on the pathophysiology and ongoing debates over the therapy of this challenging disease.