Coronary slow flow phenomenon: description of three cases evaluated with myocardial perfusion scintigraphy.

The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed opacification (TIMI 2 flow) of the epicardial coronary arteries in the absence of significant stenosis, spasm, dissection or thrombus1. This poorly understood phenomenon has been merely considered an angiographic curiosity and thus received little attention. However, patients with CSFP often have recurrent episodes of chest pain frequently requiring hospitalization2-4, even if inducible myocardial ischemia cannot always be proven5. Although the pathophysiology of this phenomenon is not clearly known, it seems correlated with an anatomic luminal reduction of the small coronary arteries6,7 as well as with a functional component such as an increased basal coronary microvascular tone4,5,8,9. We describe 3 cases of patients with CSFP, who had chest pain and myocardial perfusion defects.