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https://hdl.handle.net/2440/88671
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Type: | Book chapter |
Title: | The coronary slow flow phenomenon |
Author: | Beltrame, J. Ganz, P. |
Citation: | Chest pain with normal coronary arteries: a multidisciplinary approach, 2013 / Kaski, J., Eslick, G., Bairey Merz, C. (ed./s), vol.9781447148388, Ch.10, pp.101-117 |
Publisher: | Springer London |
Publisher Place: | USA |
Issue Date: | 2013 |
ISBN: | 1447148371 9781447148371 |
Editor: | Kaski, J. Eslick, G. Bairey Merz, C. |
Statement of Responsibility: | John Beltrame and Peter Ganz |
Abstract: | The coronary slow flow phenomenon (CSFP) is a microvascular coronary disorder, characterised angiographically by delayed contrast opacification of the distal vasculature in the absence of obstructive coronary artery disease. Its prevalence has been reported as 1–3 % of coronary angiograms performed. It often presents initially as an acute coronary syndrome with 8 % of patients having positive cardiac markers for myocardial infarction. Although transient T wave changes are frequently observed during the acute episode, only a third of patients have clinical evidence of inducible myocardial ischaemia. Both structural and functional studies have demonstrated the presence of microvascular coronary dysfunction however the underlying cause remains elusive. Possible pathogenetic mechanisms include a defective endothelial nitric oxide pathway, excessive endothelin mediated vasoconstriction, autonomic dysfunction, platelet dysfunction, metabolic derangements (associated with the metabolic syndrome and hyperhomocystinaemia), and vascular inflammation. The risk of future cardiac events following the initial presentation appears low however many patients continue to experience recurrent chest pain. Further well-controlled therapeutic studies are required to identify effective therapies for this disabling condition. |
Keywords: | Coronary slow flow phenomenon Microvascular coronary dysfunction Slow flow Syndrome X Syndrome Y Microvascular angina Coronary heart disease Normal angiogram Mibefradil Nebivolol Trimetazidine Statins Dipyridamole Endothelin Endothelial dysfunction Coronary flow reserve Microvascular disease |
Description: | Copyright © 2007 Elsevier B.V. All rights reserved. |
Rights: | © Springer-Verlag London 2013 |
DOI: | 10.1007/978-1-4471-4838-8_10 |
Published version: | http://dx.doi.org/10.1007/978-1-4471-4838-8_10 |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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