Coronary ectasia with slow flow related to apical hypertrophic cardiomyopathy--a case report.

Coronary ectasia (CE) has been reported to be associated with a high risk of coronary events and caused by several etiologies. The authors present a patient with CE who was noted to have an ECG abnormality in routine health check. Coronary angiography revealed diffuse ectasia in all 3 coronary arteries. The flow of contrast medium was slow and focal squeezing signs were observed in the left coronary artery. Echocardiography indicated mild apical hypertrophy and significant reduction of coronary flow reserve. Exercise thallium scintigraphy exhibited a transient perfusion defect in the inferior region. This is the first case report that a mild apical hypertrophy induced severe CE with slow coronary flow. The authors recommend a long-term prophylaxis of thrombotic complications with antiplatelet agents in patients with CE.