This condition, which may affect one or all coronaries, was originally described by Tambe et al. Representative angiographic images of CSFP and normal subjects are shown in Movies 1, 2. In this article, we will summarize the characteristics, possible mechanisms, and clinical implications of this entity to provide further insight into its clinical significance and management strategies.Īlthough a number of formal definitions have been proposed, the CSFP essentially consists of a delay in the progression of the contrast injected into the coronary arteries during coronary angiography. However, current clinical practice tends to underestimate the impact of CSFP due to the yet unknown mechanisms, its relative rarity, and the subsequent difficulties in conducting randomized trials to evaluate different treatment options. Rather than representing a simple angiographic curiosity, CSFP has direct clinical implications, as it has been linked to clinical manifestations of myocardial ischemia, life-threatening arrhythmias, sudden cardiac death, and recurrent acute coronary syndromes ( 1- 4). Although it is well-known to interventional cardiologists for approximately four decades, the pathogenic mechanisms are incompletely understood. The coronary slow flow phenomenon (CSFP) is an angiographic clinical entity, characterized by delayed distal vessel opacification in the absence of significant epicardial coronary stenosis. Coronary slow flow phenomenon coronary tree chest pain
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