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Slow coronary flow--a cause for angina with ST segment elevation and normal coronary arteries. A case report
1Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
International Journal of Cardiology
|January 23, 1999
Insights
Three patients experienced angina-like chest pain with ST segment elevation. This occurred despite normal coronary arteries, indicating slow coronary flow without significant blockages or spasms.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Angina-like chest pain is a common symptom requiring thorough investigation.
- Coronary artery disease (CAD) is a primary cause of chest pain, often involving obstructive lesions or vasospasm.
Observation:
- Three cases presented with chest pain and ST segment elevation.
- Coronary angiography revealed slow coronary flow.
- No significant obstructive coronary artery disease or epicardial spasm was identified.
Findings:
- Slow coronary flow (SCF) can manifest as angina and ST elevation.
- SCF may present without obstructive CAD or major coronary vasospasm.
- This challenges traditional diagnostic paradigms for ischemic chest pain.
Implications:
- Highlights the importance of considering SCF in patients with ischemic symptoms and non-obstructive coronary arteries.
- Suggests potential underlying mechanisms for SCF beyond epicardial spasm or atherosclerosis.
- Underscores the need for further research into the diagnosis and management of SCF.
Abstract:
We report three cases of angina-like chest pain with documented ST segment elevation and slow coronary flow in the absence of any significant obstructive coronary artery disease and no evidence of any major epicardial coronary arterial spasm.