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August 12, 2009

Evaluating Patients With Persistent Chest Pain and No Obstructive Coronary Artery Disease

JAMA. 2009;302(6):622-624. doi:10.1001/jama.2009.1096

To the Editor: Dr Phan and colleagues1 summarized the evaluation and management of patients with persistent chest pain and no obstructive coronary artery disease (CAD). This review did not include the coronary slow flow phenomenon, although the first patient described in the article exhibited many of its characteristics. The importance of properly diagnosing the coronary slow flow phenomenon relates to (1) its prompt identification from routine diagnostic angiography, without the need for additional invasive testing; (2) its well-documented clinical features and prognosis; and (3) potentially effective therapy established in a randomized, double-blind, placebo-controlled trial.

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