Images in Clinical Medicine
High-Resolution Imaging of Myocardial Bridging
N Engl J Med 2008; 358:392January 24, 2008
- Article
A 57-year-old man presented with a sudden onset of chest pain, which suggested the possibility of myocardial infarction. Coronary angiography revealed a myocardial bridge in the left anterior descending coronary artery. The myocardial bridge decreased the diameter of the artery substantially during systole (Panel A, with arrow pointing to myocardial bridge). Optical coherence tomography showed no evidence of atherosclerosis but did show vessel patency during diastole (Panel B) and collapse during systole (Panel C). A myocardial bridge is a band of myocardial tissue overlying a segment of epicardial coronary artery. Myocardial bridging is a congenital abnormality that typically occurs in the midsegment of the left anterior descending coronary artery. This usually benign condition has been associated with angina, myocardial infarction, ventricular tachycardia, and sudden death. Factors associated with the risk of symptomatic myocardial bridging include the length and thickness of the bridge and the severity of systolic compression. Symptoms can be treated with negative inotropic and chronotropic medications, such as beta-blockers, calcium antagonists, or a combination of both. Percutaneous stenting or bypass surgery may be required in refractory cases. This patient was treated successfully with beta-blockers.
Dirk Bose, M.D.
Sebastian Philipp, M.D.
West German Heart Center Essen, D-45147 Essen, Germany
sebastian.philipp@uk-essen. de - Citing Articles (2)
Citing Articles
1
Ananda Sunnassee, Zhu Shaohua, Ren Liang, Liu Liang. (2011) Unexpected death of a young woman: is myocardial bridging significant?—A case report and review of literature. Forensic Science, Medicine, and Pathology 7:1, 42-46
CrossRef2
Iacopo Olivotto, Franco Cecchi, Roberta Bini, Silvia Favilli, Bruno Murzi, Ismail El-Hamamsy, Magdi H Yacoub. (2008) Tunneled left anterior descending artery in a child with hypertrophic cardiomyopathy. Nature Clinical Practice Cardiovascular Medicine 6:2, 134-139
CrossRef
