CASE REPORTSThe relationship between intermittent left bundle-branch block and slow coronary flow in a patient presenting with acute coronary syndromeAcikel, Sadik; Bozkaya, Ozlem Akcinar; Akdemir, RamazanAuthor Information Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara, Turkey Received 22 October, 2009 Revised 22 March, 2010 Accepted 26 March, 2010 Correspondence to Sadik Acikel, Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, 06110 Ankara, Turkey Tel: +90 312 5962943; fax: +90 312 3186690; e-mail: firstname.lastname@example.org Blood Coagulation & Fibrinolysis: September 2010 - Volume 21 - Issue 6 - p 595-597 doi: 10.1097/MBC.0b013e32833a901c Buy Metrics Abstract 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. © 2010 Lippincott Williams & Wilkins, Inc.