Coronary Microvascular Spasm as the Underlying Cause of the Angiographic Slow Flow Phenomenon

Valeria Martínez Pereyra; Andreas Seitz; Astrid Hubert; Heiko Mahrholdt; Raffi Bekeredjian; Udo Sechtem; Peter Ong

doi:10.1016/j.jaccas.2019.11.059

Coronary Microvascular Spasm as the Underlying Cause of the Angiographic Slow Flow Phenomenon

JACC Case Rep. 2020 Jan 15;2(1):35-39. doi: 10.1016/j.jaccas.2019.11.059. eCollection 2020 Jan.

Authors

Valeria Martínez Pereyra¹, Andreas Seitz¹, Astrid Hubert¹, Heiko Mahrholdt¹, Raffi Bekeredjian¹, Udo Sechtem¹, Peter Ong¹

Affiliation

¹ Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany.

Abstract

Slow coronary flow is frequently seen during angiography in patients with angina and unobstructed coronary arteries. However, the pathophysiology of this finding remains largely unclear. We report a case of a 52-year-old woman with slow coronary flow caused by acetylcholine-induced microvascular spasm, as confirmed by intracoronary flow measurements. (Level of Difficulty: Beginner.).

Keywords: ACh, acetylcholine; CAD, coronary artery disease; CFR, coronary flow reserve; FFR, fractional flow reserve; LAD, left anterior descending artery; NYHA, New York Heart Association; coronary flow; coronary microvascular spasm; coronary vasomotor disorders; microvascular dysfunction; slow coronary flow.

Publication types

Case Reports