ST elevation during treadmill exercise test in a young patient with slow coronary flow: a case report and review of literature.

The coronary slow flow phenomenon is an angiographic curiosity characterized by delayed distal vessel opacification provided that the presence of significant epicardial coronary disease is excluded. Slow flow phenomenon in epicardial coronary arteries is not infrequent finding during routine coronary angiography. However, the clinical features of patients with slow flow phenomenon have not been extensively studied. ST elevation in leads without Q waves during exercise testing has not been previously reported in patients with slow flow phenomenon. In the current case, we report a 29-year-old man with angiographically normal coronary arteries associated with slow coronary flow in the absence of any significant obstructive coronary artery disease and no evidence of epicardial coronary artery spasm in whom ST segment elevation in leads I and aVL was observed at maximal exercise of treadmill test.