The relationship between intermittent left bundle-branch block and slow coronary flow in a patient presenting with acute coronary syndrome.
Coronary slow flow phenomenon (CSFP) is characterized by delayed opacification of coronary vessels in a normal coronary angiogram. The incidence of CSFP is reportedly 1% among patients undergoing coronary angiography, and is more prevalent in patients presenting with acute coronary syndromes (ACS). Over 80% of patients with CSFP experience recurrent chest pain. A relationship between CSFP and ventricular arrhythmias has also been reported. Left bundle-branch block (LBBB) is a strong, independent predictor of heart failure, sudden cardiac death, cardiovascular death, and all-cause death. New onset LBBB has also been shown to be prognostic for patients with ACS, and should be considered in risk stratification to identify high-risk patients. We report intermittent LBBB associated with CSFP in a patient presenting with ACS. We propose that LBBB may be a result of coronary ischemia secondary to CSFP in left anterior descending coronary artery and that intermittent LBBB may have a prognostic role for detecting coronary ischemia.
Acikel
Sadik
S
Department of Cardiology, Ministry of Health Dişkapi Yildirim Beyazit Research and Educational Hospital, Ankara, Turkey. sadik.acikel@tkd.org.tr
Bozkaya
Ozlem Akcinar
OA
Akdemir
Ramazan
R
D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D000328:Adult; D002037:Bundle-Branch Block / Q000209:etiology; D003331:Coronary Vessels / Q000503:physiopathology; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D054318:No-Reflow Phenomenon / Q000150:complications*; D011379:Prognosis