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The coronary slow flow phenomenon--a new coronary microvascular disorder
John F Beltrame1, Sananand B Limaye, John D Horowitz
1Cardiology Unit, North Western Adelaide Health Service, Queen Elizabeth Hospital Campus, Adelaide University, 28 Woodville Road, Woodville South, SA 5011, Australia. john.beltrane@adelaide.edu.au
Abstract:
The coronary slow flow phenomenon is an angiographic finding characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. Case-control and observational studies of patients with this phenomenon were conducted to determine the associated clinical features and prognosis. Patients with coronary slow flow (n = 47) differed from controls (n = 47), more often being current smokers (32 vs. 9%; p < 0.01) and presenting with rest pain requiring urgent admission (74 vs. 21%; p < 0.001), usually to the coronary care unit (66 vs. 17%; p < 0.01). During a median 21-month follow-up of 64 slow flow patients, 84% had recurrent chest pain. Based upon these findings and those of previous investigators, it is speculated that coronary slow flow is a new disease entity characterized by acute but recurrent perturbations of microvascular function.