A Case of Slow Coronary Flow Presented with Supraventricular Tachycardia and Troponin Positive Acute Coronary Syndrome

Öz

Slow coronary flow (SCF) but normal epicardial coronary arteries phenomenon frequently have asymptomatic course, however, some reports have showed that this phenomenon may cause angina pectoris, myocardial ischemia and infarction. We described a patient presented with supraventricular tachycardia and Troponin elevation and whose coronary angiography's had previously revealed slow flow in entire major epicardial coronary arteries.

Anahtar Kelimeler

• Slow coronary flow, supraventricular tachycardia and non ST-segment elevation myocardialinfarction

Supraventriküler Taflikardi ve Troponin Pozitif Akut Koroner Sendromla Baflvuran Koroner Yavafl Ak›m Olgusu

Öz

Epikardiyal koroner arterlerin normal olup ak›m›n yavafl olmas› fenomeni s›kl›kla asemptomatik bir gidifle sahiptir fakat, baz› raporlar bu fenomenin angina pektoris, miyokardial iskemi ve infarktüse yol açabilece¤ ini göstermektedir. Biz, supraventriküler taflikardi ve Troponin pozitifli¤i ile baflvuran, daha önceden yap›lan anjiografisinde tüm majör epikardial koroner arterinde yavafl ak›m saptanan bir hastay› sunduk.

Anahtar Kelimeler

• koroner yavafl ak›m, supraventriküler taflikardi ve ST segment elevasyonsuz miyokardinfarktüsü

Kaynakça

1. 1. Tambe AA, Demany MA, Zimmerman HA, Mascarenhas E. Angina pectoris and slow flow velocity of dye in coronary arteries. A new angiographic finding. Am Heart J 1972;84:66-71.
2. 2. Kapoor A, Goel PK, Gupta S. Slow coronary flow-a cause for angina with ST segment elevation and normal coronary arteries. A case report. Int J Cardiol 1998;67:257-61.
3. 3. Cesar LA, Ramires JA, Serrano Junior CV, et al. Slow coronary run off in patients with angina pectoris: clinical significance and thallium 201 scintigraphic study. Brazilian J Med Biol Res 1996;29:605-13.
4. 4. Kemp HG, Vokonas PS, Cohn PF, Gorlin R: The anginal syndrome associated with normal coronary arteriograms: Report of six year experience. Am J Med 1973;54:735-42.
5. 5. Ochene IS, Shay MJ, Alpert Jr. Unexplained chest pain in patients with normal coronary arteriograms. N Eng J Med 1980;303:1249-52.
6. 6. Mangieri E, Macchiarelli G, Ciavolella M, et al. Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries. Cathet and Cardiovasc Diagn 1996;37:375-81.
7. 7. Sezgin AT, Sigirci A, Barutcu I, et al. Vascular endothelial function in patients with slow coronary flow. Coronary Artery Disease 2003;14:155-61.
8. 8. Milleron O, Boccara F, Sauguet A, Benyounes N, Bardet J, Cohen A. A new cause of increased troponin levels: junctional tachycardia. Arch Mal Coeur Vaiss 2003; 96:75-8.

9. 9. Zellweger M J, Schaer B A, Cron T A, Pfisterer M E, Osswald S. Elevated troponin levels in absence of coronary artery disease after supraventricular tachycardia. Swiss Med Wkly 2003;133:439-41.
10. 10. Bakshi T K, Choo M K, Edwards C C, Scott A G, Hart H H, Armstrong G P. Causes of elevated troponin I with a normal coronary angiogram. Intern Med J 2002 ; 32:520-5.