The Application of Coronary Contrast Emptying Time in Diagnosing Coronary Slow Flow Phenomenon: A Serial Case Report

Yudhie Tanta1, Ali Ghanie, Taufik Indrajaya

  • 1Division of Cardiovascular, Department of Internal Medicine, Faculty of Medicine Universitas Sriwijaya - Dr. Mohammad Hoesin Hospital, Palembang, Indonesia.. tanta7an7a@yahoo.com.

Acta Medica Indonesiana
|January 10, 2023
PubMed

Insights

Coronary slow flow phenomenon, often overlooked, can cause acute coronary syndromes. Prolonged coronary contrast emptying time, not delayed filling, may be a more consistent indicator in these cases.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Coronary slow flow phenomenon (CSFP) is often underestimated, considered benign.
  • However, CSFP can present as acute coronary syndrome, myocardial ischemia, arrhythmia, and sudden cardiac death.

Observation:

  • CSFP diagnosis typically relies on delayed coronary contrast filling during angiography without significant epicardial narrowing.
  • Clinical experience reveals cases of myocardial ischemia/infarction with normal angiography findings for filling time.
  • These cases often show prolonged coronary contrast emptying time instead.

Findings:

  • This case series suggests microvascular disorders in some CSFP patients.
  • Delayed coronary contrast filling was not consistently observed in ischemic arteries.
  • Prolonged coronary contrast emptying time emerged as a more reliable indicator.

Implications:

  • Re-evaluation of diagnostic criteria for CSFP is warranted.
  • Microvascular dysfunction may play a significant role in CSFP.
  • Focusing on contrast emptying times could improve diagnosis and management of CSFP.

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