Slow Coronary Flow Angina

At present, angina defines has four types, including the stable angina pectoris, unstable angina, Prinzmetal’s variant angina and X syndrome. The descriptions of angina which caused by other pathological mechanism are very little. This article is a detailed account of angina which is caused by the slow of coronary artery blood stream. We put forward a new type of angina:the angina which is caused by slow coronary flow phenomena is defined as slow coronary flow angina(SCFA).As early as1972the slow coronary flow phenomena (SCFP) have been found, but the etiology and pathogenesis of which is still unclear. Recent studies indicate that smoking, high homocysteine, obesity, high uric acid and mean platelet volume increases are closely related to the onset of SCFP. Microangiopathy, endothelial dysfunction, inflammation, the early performance of coronary artery atherosclerosis, platelet form and dysfunction may also be involved in the pathophysiology of SCFP and play an important role. SCFP can cause myocardial ischemia, which may lead to angina pectoris or acute coronary syndrome or even sudden death. At present the coronary artery angiography is the main method to determine the coronary artery blood flow velocity and make the diagnosis of slow coronary flow angina. Both slow coronary flow angina and X syndrome are capillary pathological changes. There are no clear boundaries to distinguish them. They are identified generally according to gender, risk factors, clinical symptom and results of coronary angiography. The pathogenesis of coronary slow flow phenomena is unclear, so there’s not an exact treatment for these phenomena. In clinic we mainly to give them the following treatments, such as expanding capillaries, antiplatelet therapy, improving endothelial function, anti-inflammatory therapy, reducing homocysteine level and improving cardiac energy metabolism. Also this article puts forward a new treatment method: external counterpulsation treatment, and clarifies the mechanism of external counterpulsation treat slow coronary flow angina. Due to not enough attention to slow coronary flow angina have been taken in clinic, part of angina pectoris patients are missed diagnosis, and not given appropriate medical treatment. This situation lead to angina pectoris repeated attack and the quality of life descend to patients. So we should paid attention to this phenomenon.