The rare complication of Behcet's syndrome: concomitance of coronary slow flow with acute coronary syndrome.

DESCRIPTION Coronary slow flow (CSF) is a phenomenon characterised by delayed opacification of coronary arteries in the absence of epicardial stenosis, in which microvascular and endothelial dysfunction have been implicated in pathophysiology. The association between acute coronary syndromes (ACS) and Behcet’s syndrome is well known but rare, and is especially important due to the tendency to affect young subjects. Besides CSF, vasculitis, aneurysms, coronary vasospasm and thrombo-embolic phenomena may also lead to ACS in Behcet’s syndrome. 3 Vascular endothelial cell injury and resultant endothelial dysfunction seem to play a role in the CSF leading to ACS. 2 We report a patient with Behcet’s syndrome, and history of hypertension who had CSF presenting with severe myocardial ischemia leading to ACS. A 54-year-old woman was admitted with 2 hours of severe retrosternal chest pain and nausea. Physical