Coronary Slow-Flow Syndrome: A Review on Natural History of Disease and Best Practices

Muhammad  Iqhrammullah; Derren  Rampengan

doi:10.18502/jthc.v20i1.19222

Muhammad Iqhrammullah Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, Indonesia.
Derren Rampengan Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia.

DOI: https://doi.org/10.18502/jthc.v20i1.19222

Keywords: Angiography, Coronary Arterial Diseases, Coronary Slow Flow, Natural History of Disease, TIMI Frame Count

Abstract

Coronary slow flow (CSF) poses significant clinical challenges, marked by delayed coronary blood flow despite angiographically normal epicardial arteries. With a prevalence of 1% to 7%, the underlying pathogenesis and clinical manifestations of this condition remain incompletely understood. This review examines the natural history of CSF, including its pathophysiological mechanisms, ranging from inflammatory cascades to microvascular dysfunction. Diagnostic approaches, such as corrected TIMI frame count, scintigraphy, and ECG analysis, provide valuable insights into its complex presentation. Further, the review outlines management strategies, focusing on pharmacological interventions like calcium channel blockers and anti-inflammatory agents. Understanding CSF’s natural history is crucial for implementing effective preventive measures, spanning primary to tertiary prevention. Still, further research is essential to fully elucidate its pathophysiology and optimize therapeutic strategies for improving patient outcomes in this complex disorder.