INTRODUCTION. Isolated coronary slow-flow phenomenon, being a lesion of the distal microvascular bed, may have an unfavorable prognosis, but usually does not require surgical revascularization. The genesis of delayed coronary flow in patients with symptomatic stenotic coronary lesion requires special attention in terms of surgical tactics, as it is not reversible in all cases. The OBJECTIVE of the research was to study the coronary slow-flow phenomenon in a model of long-term chronic infection. METHODS AND MATERIALS. 68 patients with pulmonary tuberculosis with clinical or instrumental data of myocardial ischemia, but without coronary artery stenosis were studied. All patients were divided into 2 groups (with and without coronary slow-flow phenomenon). A modified TIMI scale was used to estimate the velocity of the radiopaque substance. The duration of the disease and the extent of the lesion, acute-phase blood parameters, and the presence of cardiotoxic drugs in therapy were evaluated. RESULTS. Patients in the group with slowing of coronary flow had a longer duration of the disease, were characterized by a large volume of lung damage, however, there were no differences in the degree of increase in acute phase parameters of blood, the factor of bacillus excretion. CONCLUSION. The presented data indicate the need to take into account the possible presence of a coronary slow-flow phenomenon unrelated to the degree of stenosis in the tactics of surgical treatment of patients with a specific inflammatory process with symptomatic stenotic lesions of the coronary arteries. © СС Коллектив авторов, 2025