Wednesday, December 3, 2014

What is Slow Coronary Flow (SCF) Phenomenon?

Cardiologists are familiar with the phenomenon of slow progression of angiographic contrast in the coronary arteries in the absence of stenosis in the epicardial vessels in some patients presenting with chest pain. The coronary slow flow phenomenon (CSFP), first described in 1972, remains scantily studied. This phenomenon should be distinguished from occurrence of slow flow in the context of coronary reperfusion therapy such as angioplasty or thrombolysis that is associated with different pathophysiological and clinical implications. Similarly, coronary slow flow associated with coronary artery spasm, coronary artery ectasia (CAE), myocardial dysfunction, valvular heart disease and certain connective tissue disorders involving coronary microvasculature is easy to understand.CSFP may occassionly also result from inadvertent air-embolism during angiography or may be due to an overlooked ostial lesion. However, it is not certain whether CSFP in the absence of any of these known causes represents merely an angiographic curiosity or has special physiologic or therapeutic implications. In this editorial we focus on the current knowledge regarding CSFP manifesting in the absence of any known etiology.

In slow Coronary Flow (SCF)  phenomenon  there is a delayed opacification opacification  of epicardial  arteries in the absence of occlusive disease.Although the pathogenesis of this syndrome is controversial, several several  studies have suggested that  it is mainly caused by endothelial microvascular dysfunction.There is also a correlation between SCF and abnormal hemorheologic  parameter.
 Hematocrit and Current Smoking (15% vs. 39%)were the only variables that were found to be were the only variables that were found to be significant when comparing the two groups of significant when comparing the two groups of patients.
In patients with normal coronary arteries coronary blood flow velocity is highly correlated
between different blood vessels and t the different measuring techniques. different measuring techniques.  Slow flow is highly correlated to Hematocrit Current Smoking,blood viscosity impairs 
blood flow.
Smoking may involve the induction of endothelial dysfunction, moreover, smoking is known to elevate hematocrit level and perhaps, by doing so, it increases blood viscosity which slower the blood flow even more.

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