Background: According to previous studies, dysfunction of coronary microcirculation (CMD) is defined as reduced coronary flow reserve and/or endothelial dysfunction, presented with typical angina in absence of other myocardial/cardiovascular or systemic diseases, with electrocardiographic ischemic changes and normal/minimally changed coronarogram. The main pathophysiologic mechanism of CMD is endothelial dysfunction with impaired vasodilatation, coagulation, inflammation, permeability, cell adhesion, and altered microvascular response. (1, 2) Aim: To determine gender difference and risk factors in patients with slow flow coronary phenomena, without significant epicardial coronary artery stenosis, and typical angina-like chest pain.

Patients and Methods: The study included 30 patients (14 males, 16 females) hospitalized because of chest pain, with ischemic electrocardiographic changes, normal coronarogram and coronary slow flow. To all patient standard biochemical blood analysis with cardiac enzymes were done, blood pressure and anthropometric measurements, transthoracic echocardiography and coronary angiography.

Results: Arterial hypertension, diabetes mellitus, dyslipidemia, nicotinismus and family history did not showed significant gender difference, but significance was found in age range (p=0.032), male patients was younger than female. Also, early stage of weight increase, BMI over 25kg/m², could present risk factor for coronary slow flow in both gender.

Conclusion: In addition to standard risk factors that underlie coronary microcirculatory disease, obesity and ageing should be considered as a part of clinical presentation and aspect for further treatment.