Coronary Slow Flow Phenomenon: A Case Report
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Published:
Sep 18, 2015
Keywords:
coronary slow flow, unstable angina, small coronary artery disease, endothelial dysfunction, intracoronary ultrasound
Main Article Content
Abstract
Angina pectoris and abnormally slow contrast propagation into the unobstructed coronary artery, the so-called coronary slow flow (CSF) phenomenon was first recognized four decades ago but the etiology remained unclear. We reported a case of CSF phenomenon presenting with acute coronary syndrome in a middle-aged man who had multiple coronary risk factors. Intracoronary ultrasound revealed no significant plaque burden in related epicardial arteries. The pathogenic mechanisms of small artery disease and the role of endothelial dysfunction are discussed and relevant literature has been reviewed.
Article Details
How to Cite
1.
Veerakul G, Ounpothi M, Satheeranate N, Waramit J, Sangwan A, Sindhuwanna U, Kawkaew T, Khengrang A. Coronary Slow Flow Phenomenon: A Case Report. BKK Med J [Internet]. 2015 Sep. 18 [cited 2024 Nov. 22];10(1):22. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/221125
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Case Report
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References
1. Mangieri E, Macchiarelli G, Ciavolella M, et al. Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries. Cathet Cardiovasc Diagn 1996;37:375-81.
2. Wang X, Nie SP. The coronary slow flow phenomenon: characteristics, mechanisms and implications. Cardiovasc Diagn Ther 2011;1:37-43.
3. Mullasari A. The Coronary Slow Flow Phenomenon. The E-journal of European Society of Cardiology council for Cardiology Practice 2013; July 4.
4. Gibson CM, Cannon CP, Daley WL, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996;93:879-88.
5. Tambe AA, Demany MA, Zimmerman HA, et al. Angina pectoris and slow flow velocity of dye in coronary arteries-a new angiographic finding. Am Heart J 1972; 84:66-71.
6. Li JJ, Wu YJ, Qin XW. Should slow coronary flow be considered as a coronary syndrome? Med Hypotheses 2006;66:953-6.
7. Leone MC, Gori T, Fineschi M. The coronary slow flow phenomenon: a new cardiac “Y” syndrome? Clin Hemorheol Microcirc 2008;39:185-90.
8. Fineschi M, Gori T. Coronary slow-flow phenomenon or syndrome Y: a microvascular angina awaiting recognition. J Am Coll Cardiol 2010;56:239-40.
9. Goel PK, Gupta SK, Agarwal A, et al. Slow coronary flow: a distinct angiographic subgroup in syndrome X. Angiology 2001;52: 507-14.
10. Chaudhry MA, Smith M, Hanna EB, et al. Diverseof Coronary Slow Flow Phenomenon: A Concise Review of the Literature. Cardiol Res and Practice 2012.
11. Saya S, Hennebry TA, Lozano P, et al. Coronary Slow Flow Phenomenon and Risk for Sudden Cardiac Death Due to Ventricular Arrhythmias. Clin Cardiol 2007; 31:352-5.
12. Wozakowska-Kaplon B, Niedziela J, Krzyzak P, et al. Clinical manifestations of slow coronary flow from acute coronary syndrome to serious arrhythmias. Cardiol J 2009;16:462-8.
13. Beltrame JF, Limaye SB, Horowitz JD. The coronary slow flow phenomenon-a new coronary microvascular disorder. Cardiol 2002;97:197-202.
14. Binak E, Gunduz H, Sahin M, et al. The relation between glucose tolerance and slow coronary flow. Int J Cardiol 2006; 111:142-6.
15. Yilmaz H, Demir I, Uyar Z. Clinical and coronary angiographic characteristics of patients with coronary slow flow. Acta Cardiol 2008;63:579-84.
16. De Caterina R, Massaro M, Libby P. Endothelial functions and dysfunctions. In Caterina RD, Libby P, ed. Endothelial Dysfunctions and Vascular Disease, Blackwell Futura 2007:3-25.
17. Mosseri M, Yarom R, Gotsman MS, et al. Histologic evidence for small-vessel coronary artery disease in patients with angina pectoris and patent large coronary arteries. Circulation 1986;74:964-72.
18. Mangieri E, Macchiarelli G, Ciavolella M, et al. Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries. Cathet cardiovasc Diagn 1996;37:375-81.
19. Kurtoglu N, Akcay A, Dindar I. Usefulness of oral dipyridamole therapy for angiographic coronary slow flow. Am J Cardiol 2001;87:777-9.
20. Beltram JF, Turner SP, Leslie SL, et al. The angiographic and clinical benefits of mibifradil in the coronary slow flow phenomenon. J Am Coll Cariol 2004;44:57-62.
21. Albayrak S, Ordu S, Yuksel H, et al. Efficacy of nebivolol on flow-mediated dilatation in patients with slow coronary slow. Int Heart J 2009;50:545-53.
22. Fragasso G. Nebivolol in patients with coronary slow flow: the right drug for the right case? Anadolu Kardiyol Derg 2009;9:296-7.
23. Cakmak M, Tanriverdi H, Cakmak N, et al. Simvastatin may improve myocardial perfusion abnormality in slow coronary flow. Cardiology 2008; 110:39-44.
24. Li JJ, Zheng X, Li J. Statins may be beneficial for patients with slow coronary flow due to its anti-inflammatory property. Med Hypotheses 2007;69:333-7.
25. Caliskan M, Erdogan D, Gullu H, et al. Effects of atorvastatin on coronary flow reserve in patients with slow coronary flow. Clin Cardiol 2007;30:475-9.
26. Antman EM, DeMets D, Loscalzo J. Cyclooxygenase Inhibition and Cardiovascular Risk, special report. Circulation 2005; 112: 759-70.
27. McAdam BF, Byrne D, Morrow JD, Oates JA. Contribution of Cyclooxygensae-2 to Elevated Biosynthesis of Thromboxane A2 and Prostacyclin in Cigarette Smokers. Circulation 2005;112:1024-9.
2. Wang X, Nie SP. The coronary slow flow phenomenon: characteristics, mechanisms and implications. Cardiovasc Diagn Ther 2011;1:37-43.
3. Mullasari A. The Coronary Slow Flow Phenomenon. The E-journal of European Society of Cardiology council for Cardiology Practice 2013; July 4.
4. Gibson CM, Cannon CP, Daley WL, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996;93:879-88.
5. Tambe AA, Demany MA, Zimmerman HA, et al. Angina pectoris and slow flow velocity of dye in coronary arteries-a new angiographic finding. Am Heart J 1972; 84:66-71.
6. Li JJ, Wu YJ, Qin XW. Should slow coronary flow be considered as a coronary syndrome? Med Hypotheses 2006;66:953-6.
7. Leone MC, Gori T, Fineschi M. The coronary slow flow phenomenon: a new cardiac “Y” syndrome? Clin Hemorheol Microcirc 2008;39:185-90.
8. Fineschi M, Gori T. Coronary slow-flow phenomenon or syndrome Y: a microvascular angina awaiting recognition. J Am Coll Cardiol 2010;56:239-40.
9. Goel PK, Gupta SK, Agarwal A, et al. Slow coronary flow: a distinct angiographic subgroup in syndrome X. Angiology 2001;52: 507-14.
10. Chaudhry MA, Smith M, Hanna EB, et al. Diverseof Coronary Slow Flow Phenomenon: A Concise Review of the Literature. Cardiol Res and Practice 2012.
11. Saya S, Hennebry TA, Lozano P, et al. Coronary Slow Flow Phenomenon and Risk for Sudden Cardiac Death Due to Ventricular Arrhythmias. Clin Cardiol 2007; 31:352-5.
12. Wozakowska-Kaplon B, Niedziela J, Krzyzak P, et al. Clinical manifestations of slow coronary flow from acute coronary syndrome to serious arrhythmias. Cardiol J 2009;16:462-8.
13. Beltrame JF, Limaye SB, Horowitz JD. The coronary slow flow phenomenon-a new coronary microvascular disorder. Cardiol 2002;97:197-202.
14. Binak E, Gunduz H, Sahin M, et al. The relation between glucose tolerance and slow coronary flow. Int J Cardiol 2006; 111:142-6.
15. Yilmaz H, Demir I, Uyar Z. Clinical and coronary angiographic characteristics of patients with coronary slow flow. Acta Cardiol 2008;63:579-84.
16. De Caterina R, Massaro M, Libby P. Endothelial functions and dysfunctions. In Caterina RD, Libby P, ed. Endothelial Dysfunctions and Vascular Disease, Blackwell Futura 2007:3-25.
17. Mosseri M, Yarom R, Gotsman MS, et al. Histologic evidence for small-vessel coronary artery disease in patients with angina pectoris and patent large coronary arteries. Circulation 1986;74:964-72.
18. Mangieri E, Macchiarelli G, Ciavolella M, et al. Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries. Cathet cardiovasc Diagn 1996;37:375-81.
19. Kurtoglu N, Akcay A, Dindar I. Usefulness of oral dipyridamole therapy for angiographic coronary slow flow. Am J Cardiol 2001;87:777-9.
20. Beltram JF, Turner SP, Leslie SL, et al. The angiographic and clinical benefits of mibifradil in the coronary slow flow phenomenon. J Am Coll Cariol 2004;44:57-62.
21. Albayrak S, Ordu S, Yuksel H, et al. Efficacy of nebivolol on flow-mediated dilatation in patients with slow coronary slow. Int Heart J 2009;50:545-53.
22. Fragasso G. Nebivolol in patients with coronary slow flow: the right drug for the right case? Anadolu Kardiyol Derg 2009;9:296-7.
23. Cakmak M, Tanriverdi H, Cakmak N, et al. Simvastatin may improve myocardial perfusion abnormality in slow coronary flow. Cardiology 2008; 110:39-44.
24. Li JJ, Zheng X, Li J. Statins may be beneficial for patients with slow coronary flow due to its anti-inflammatory property. Med Hypotheses 2007;69:333-7.
25. Caliskan M, Erdogan D, Gullu H, et al. Effects of atorvastatin on coronary flow reserve in patients with slow coronary flow. Clin Cardiol 2007;30:475-9.
26. Antman EM, DeMets D, Loscalzo J. Cyclooxygenase Inhibition and Cardiovascular Risk, special report. Circulation 2005; 112: 759-70.
27. McAdam BF, Byrne D, Morrow JD, Oates JA. Contribution of Cyclooxygensae-2 to Elevated Biosynthesis of Thromboxane A2 and Prostacyclin in Cigarette Smokers. Circulation 2005;112:1024-9.