Diverse Spectrum of Presentation of Coronary Slow Flow Phenomenon: A Concise Review of the Literature

Chaudhry, Muhammad; Smith, Marcus; Hanna, Elias B.; Lazzara, Ralph

doi:10.1155/2012/383181

Cited by 40 publications

(47 citation statements)

References 31 publications

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“…Several studies have suggested independent predictors of the SCF phenomenon (5,7,(11)(12)(13)(18)(19)(20). In a study by Arbel et al smoking was found to be the strongest predictor of the SCF phenomenon (13).…”

Section: Comparing Scf and Neca Subjectsmentioning

confidence: 99%

“…Although some investigators have reported an SCF incidence rate of 7%, based on visual estimations, SCF is not a frequent finding in routine coronary angiograms, with an incidence of approximately 1% in patients undergoing coronary angiography (4,5). The speed of contrast agent progression through the coronary arteries can be assessed and quantified with good accuracy and reproducibility using the Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) (6).…”

Section: Introductionmentioning

confidence: 99%

“…Since its initial definition by Tambe et al, only a few studies have investigated the etiology and predisposing factors of the SCF phenomenon (4,5). This phenomenon has been suggested as an early phase of atherosclerosis that involves both the small and epicardial coronary arteries (7-10).…”

Section: Introductionmentioning

confidence: 99%

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Coronary slow flow phenomenon: Clinical findings and predictors

et al. 2016

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Background:In some patients with chest pain, selective coronary angiography reveals slow contrast agent passage through the epicardial coronary arteries in the absence of stenosis. This phenomenon has been designated the slow coronary flow (SCF) phenomenon. Objectives: In this study, we aimed to describe the demographic and clinical findings and presence of common atherosclerosis risk factors in patients with the SCF phenomenon. Patients and Methods: Between October 2014 and March 2015, demographic data, clinical histories, atherosclerosis risk factors, and laboratory and angiographic findings were recorded for all consecutive patients scheduled for coronary angiography and diagnosed with the SCF phenomenon, as well as a control group (patients with normal epicardial coronary arteries; NECA). SCF was diagnosed based on the thrombolysis in myocardial infarction frame count (TFC). A TFC > 27 indicated a diagnosis of SCF phenomenon. Results: Among the 3600 patients scheduled for selective coronary angiography, 75 (2%) met the SCF criteria. SCF and NECA patients did not exhibit statistically significant differences in traditional risk factors except for hypertension, which was more prevalent in SCF than NECA patients (52% versus 31%, P = 0.008). A multivariable analysis indicated a low body mass index, presence of hypertension, low highdensity lipoprotein cholesterol (HDL-c) level, and high hemoglobin level as independent predictors of the SCF phenomenon; of these, hypertension was the strongest predictor (odds ratio = 6.3, 95% confidence interval: 2.2 -17.9, P = 0.001). Conclusions:The SCF phenomenon is relatively frequent, particularly among patients with acute coronary syndrome who are scheduled for coronary angiography. Hypertension, a low HDL-c level, and high hemoglobin level can be considered independent predictors of this phenomenon.

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Section: Comparing Scf and Neca Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Coronary slow flow phenomenon: Clinical findings and predictors

et al. 2016

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“…[2] Recently, CSFP has been documented in adults who had anginal chest pain with elevation in the ST segment. [1,5] Doğan et al [6] reported a 15-year-old boy who had acute STEMI and anatomically normal coronary arteries. However, they described multiple prothrombotic gene polymorphisms, unlike in our patient, and considered that these polymorphisms might have contributed to the development of acute STEMI.…”

Section: Exercise Stress Testmentioning

confidence: 99%

“…The incidence of CSFP is reported as 1-5.5% among adult patients who undergo coronary angiography (CAG) with suspicion of acute coronary syndrome. [1] The presentation pattern of these patients varies widely from vague chest discomfort to myocar-dial infarction. [1][2][3] Herein, we present a child who had recurrent chest pain and acute ST-segment elevation myocardial infarction (STEMI) associated with CSFP.…”

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confidence: 99%

Chest pain with myocardial ischemia in a child: should we think about coronary slow flow phenomenon?

2013

Arch Turk Soc Cardiol

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The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed opacification of epicardial coronary arteries in the absence of stenotic lesion. Herein, we present a 13-year-old boy with recurrent chest pain who was diagnosed with acute ST-segment elevation myocardial infarction associated with CSFP, which has not been reported previously in the pediatric age group. Coronary angiography revealed only the presence of slow flow in the left anterior descending (LAD) coronary artery. Myocardial perfusion scintigraphy revealed a reversible perfusion defect in the LAD territory, which regressed partially at rest and showed complete improvement after dipyridamole infusion. All the symptoms, electrocardiogram abnormalities and cardiac markers returned to normal after dipyridamole treatment during the follow-up. We conclude that CSFP should be kept in mind in the differential diagnosis of chest pain with myocardial ischemia in the pediatric age group.

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