Patient selection: chest pain with insignificant coronary artery disease on angiography
Features of Primary Coronary Slow Flow
(1) angiographic evidence (see below)
(2) exclusion of secondary causes (no-reflow phenomenon, coronary embolus, coronary ectasia, exogeneous vasoconstricting drug)
Angiographic evidence:
(1) no evidence of obstructive epicardial coronary artery disease (no angiographic lesions >= 40%)
(2) delayed distal vessel contrast opacification in at least one epicardial coronary artery
where:
• Delayed distal vessel contrast opacification consists of one or both of the following:
(a) TIMI-2 flow (>= 3 beats to opacify the vessel)
(b) corrected TIMI frame count > 27 frames with frames acquired at 30 frames per second
