Slow Coronary Blood Flow: Pathogenesis and Clinical Implications

Area of Science:

• Cardiology
• Vascular Medicine
• Diagnostic Imaging

Background:

• Coronary slow flow (CSF) phenomenon, also termed cardiac syndrome Y, involves delayed opacification of coronary arteries.
• Potential mechanisms include microvascular and endothelial dysfunction.
• CSF is a recognized cause of myocardial ischemia detectable by non-invasive tests.

Purpose of the Study:

• To review the current understanding of the coronary slow flow phenomenon.
• To discuss its clinical presentation, incidence, and potential underlying causes.

Main Methods:

• Literature review of studies investigating coronary slow flow.
• Analysis of clinical data and diagnostic findings related to CSF.

Main Results:

• CSF is associated with delayed distal coronary vasculature opacification.
• Clinical manifestations include angina, acute coronary syndrome, and sudden cardiac death.
• Incidence is 1-5% in patients undergoing coronary angiography, often affecting young, male smokers with metabolic syndrome.

Conclusions:

• Coronary slow flow phenomenon is a significant clinical entity.
• Established treatments are lacking, highlighting the need for further research.