title: Coronary slow flow accompanying exertional blurred vision and effects of corticosteroids.
abstract: Background Various pathophysiological mechanisms such as microvascular and endothelial dysfunction, small vessel disease, diffuse atherosclerosis, and inflammation have been held responsible in the etiology of coronary slow flow. It is also thought to be a reflection of a systemic slow-flow phenomenon in the coronary arterial tree. Case Report A 44-year-old man presented with chest pain causing fatigue, together with blurred vision for the last 2 years, which disappeared after resting. He had used corticosteroid therapy for facial paralysis 1 month ago. Coronary slow flow was detected in all 3 major coronary arteries on coronary angiography. TIMI measurements for the left anterior descending artery, circumflex, and right coronary artery were 64, 72, and 55, respectively. In fundus fluorescein angiography, retinal vascularity was normal, the arm-to-retina circulation time was 21.8 s, and the arteriovenous transit time was 4.3 s. In the early arteriovenous phase, choroidal filling was long, with physiological patchy type. Diltiazem 90 mg/day and acetylsalicylic acid 100 mg/day were given. His chest pain and visual symptoms disappeared after medical treatment. Conclusions Physicians should be aware that glucocorticoids might cause an increase in the symptoms of coronary slow flow and some circulation problems, which might lead to systematic symptoms.
authors.affiliation: Department of Cardiology, Kırıkkale Yüksek İhtisas State Hospital, Kırıkkale, Turkey.
authors.forename: Şahbender
authors.initials: Ş
authors.lastname: Koç
authors.affiliation: Department of Cardiology, Giresun University, Giresun, Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Vural
authors.affiliation: Department of Cardiology, Kırıkkale Yüksek İhtisas State Hospital, Kırıkkale, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Aksoy
authors.affiliation: Department of Cardiology, Kırıkkale Yüksek İhtisas State Hospital, Kırıkkale, Turkey.
authors.forename: Barış
authors.initials: B
authors.lastname: Dindar
authors.affiliation: Department of Cardiology, Giresun University, Giresun, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karagöz
authors.affiliation: Department of Cardiology, Ordu University, Ordu, Turkey.
authors.forename: Zeki Yüksel
authors.initials: ZY
authors.lastname: Günaydın
authors.affiliation: Department of Cardiology, Ordu University, Ordu, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Bektaş
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology*; D003331:Coronary Vessels / Q000187:drug effects / Q000503:physiopathology*; D003900:Desoxycorticosterone / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D015354:Vision, Low / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*
chemical_list: D005938:Glucocorticoids; D003900:Desoxycorticosterone