Slow Coronary Flow Phenomenon Associated With Exercise-Induced Myocardial Ischemia

İrfan Barutcu; Alpay Turan Sezgin; Hakan Güllü; Ali Metin Esen

İrfan Barutcu¹, Alpay Turan Sezgin², Hakan Güllü², Ali Metin Esen¹

¹Department of Cardiology, Koşuyolu Heart and Research Hospital, İstanbul;
²Department of Cardiology, Başkent University Adana Training and Research Hospital, Adana

Slow coronary flow in the presence of normal epicardial coronary arteries frequently has an asymptomatic course; however, some reports have showed its pathologic potential. A 35-year-old male patient was admitted with a history of exertional angina (Canadian class II) of a year duration. During treadmill exercise stress testing, he experienced typical angina pectoris and a 2-mm ST-segment depression. Coronary angiography revealed slow flow in the right coronary artery without any other coronary pathology. Medications with aspirin, nitroglycerin, and a beta-blocker were instituted, after which relief of symptoms was observed. His complaints did not recur during a follow-up period of a year.

Keywords : Angina pectoris; blood flow velocity; chest pain/etiology; coronary angiography; coronary circulation; coronary disease; exercise test; vascular resistance

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