Coronary Slow Flow Phenomenon Leads to ST Elevation Myocardial Infarction
Recently, a 39 year-old female patient was admitted to our emergency room with new onset chest pain. The chest pain was described as a pressure-like sensation in the center of her chest, 8/10 in severity, and radiated down her left arm. She had no previous medical history. Also, she had no inherent risk factors except for smoking. Her electrocardiography revealed an ST elevation of approximately 3 mm in the anterior precordial leads (). This patient was immediately taken into the catheter laboratory with a diagnosis of hyperacute anterior myocardial infarction. Coronary angiography showed slow dye flow and delayed distal vessel clearance in the left anterior descending coronary artery (LAD) (). Coronary arteries were normal except for some plague in the left and right coronary artery (RCA). Her corrected Thrombolysis in Myocardial Infarction (TIMI) frame count (CTFC) for the LAD was 34.1 (normal range 21±3). The TIMI frame count for the RCA was 15 and the circumflex artery was 20 (). Following the angiography, her chest pain stopped. The ST elevation came to the isolelectric line. T waves were negative in V 3-6 leads (). The troponin T level elevated mildly to 0.28 ng/mL (>0.1 ng/mL positive) but the creatine kinase-MB level was normal. Her laboratory findings were completely normal. Her body mass index was 26. Transthoracic echocardiography revealed normal left ventricular function, and mild mitral regurgitation without no segmentary wall motion disturbance. During hospitalization, the patient was stable and chest pain did not recur. The patient was discharged with 100 mg acetylsalicylic acid and 5 mg nebivolol treatment after 3 days of hospitalization.