Abstract

Objective: This study aimed to determine the prevalence and clinical, laboratory, echocardiographic, and angiographic characteristics of coronary slow flow phenomenon (CSFP) among patients undergoing coronary angiography at King Abdullah Medical Complex, Jeddah.
Methods: This retrospective observational study included adult patients who underwent diagnostic coronary angiography between September and November 2024. Patients presenting with ST-segment elevation myocardial infarction (STEMI), non-STEMI, unstable angina, or nonobstructive coronary arteries (27 frames).
Results: Among 228 eligible patients, CSFP was identified in 10 cases, yielding a prevalence of 4.4%. Baseline demographics and traditional cardiovascular risk factors were similar between the CSFP and non-CSFP groups. Patients more frequently presented with atypical chest pain and orthopnea. Laboratory parameters were largely comparable, except for higher high-density lipoprotein cholesterol levels in the CSFP group. The left anterior descending artery was the most commonly affected vessel. Patients demonstrated preserved left ventricular systolic function and fewer regional wall motion abnormalities. Clinically and electrocardiographically, unstable angina predominated in CSFP, whereas STEMI occurred exclusively in the non-CSFP group.
Conclusion: CSFP prevalence in this center aligns with international reports. It was found to be associated with ischemic symptoms, preserved systolic function, minimal myocardial involvement, and unstable angina, highlighting the need for clinical awareness and standardized diagnostic criteria.

Key words: Coronary slow-flow phenomenon, microvascular angina, TIMI frame count, coronary angiography, unstable angina, non-obstructive coronary artery disease TIMI Frame Count Non-Obstructive Coronary Artery Disease Unstable Angina Coronary Angiography