Myocardial bridging causing transmural ischemia Successful coronary artery bypass surgery

Abstract Myocardial bridging is a common and usually benign inborn coronary anomaly. We report on a 51-year-old man who presented with recent angina on minimum physical effort. Cineangiography showed myocardial bridging of the mid-left anterior descending artery (LAD), and intracoronary ultrasonogra...

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Bibliographic Details
Published inInternational journal of cardiology Vol. 115; no. 1; pp. E49 - E51
Main Authors Vianna, Caio B, Gonzalez, Maria M, Jatene, Fabio B, Gama, Marcus N, Timerman, Sergio, Cesar, Luiz A
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ireland Ltd 31.01.2007
Subjects
Angina Pectoris - etiology
Cardiovascular
Coronary Artery Bypass
Coronary vasospasm
Coronary Vessel Anomalies - complications
Coronary Vessel Anomalies - diagnosis
Coronary Vessel Anomalies - surgery
Coronary Vessels
Humans
Intravascular ultrasound
Ischemia
Male
Middle Aged
Myocardial bridging
Myocardial bridging
Ischemia
Coronary vasospasm
Coronary artery bypass
Intravascular ultrasound
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Summary:Abstract Myocardial bridging is a common and usually benign inborn coronary anomaly. We report on a 51-year-old man who presented with recent angina on minimum physical effort. Cineangiography showed myocardial bridging of the mid-left anterior descending artery (LAD), and intracoronary ultrasonography excluded atherosclerotic disease. Gated single-photon emission computed tomography (SPECT), with exercise stress, showed an extensive anterior perfusion defect, and remarkable ST-segment elevation (up to 10 mm) in recovery. Vasospasm of the LAD was the main hypothesis. Additional oral drugs did not bring about improvement, as indicated on a new SPECT; disabling angina persisted. Surgical revascularization of the LAD by left internal mammary artery graft was performed. Two years later, SPECT and exercise tests returned to normal. The patient remains asymptomatic.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2006.07.159