Korean J Anesthesiol.  2005 Oct;49(4):550-553. 10.4097/kjae.2005.49.4.550.

Myocardial Infarction in a Patient with Myocardial Bridge and Pheochromocytoma: A case report

• Lee KY
• Kwak KH
• Kim SO

• KMID: 1936861
• DOI: http://doi.org/10.4097/kjae.2005.49.4.550

Abstract

A myocardial bridge is an anatomical anomaly in which an epicardial coronary artery becomes engulfed in a limited segment by myocardial fibers. Myocardial ischemia, infarction and sudden death can occur some patients with a myocardial bridge. However, the clinical course can be worse if pheochromocytoma coexists with a myocardial bridge. We experienced anesthetic management of a 52-year-old female patient with a history of myocardial infarction associated with a myocardial bridge and pheochromocytoma. The goal of anesthesia is to avoid hypertension and tachycardia. Nitroglycerin, as a coronary vasodilator, can aggravate the degree of systolic narrowing of the coronary artery. This finding appears to conflict with ordinary management for cardiac ischemia.

Keyword

myocardial bridge; myocardial infarction; pheochromocytoma

MeSH Terms

Anesthesia
Coronary Vessels
Death, Sudden
Female
Humans
Hypertension
Infarction
Ischemia
Middle Aged
Myocardial Infarction*
Myocardial Ischemia
Nitroglycerin
Pheochromocytoma*
Tachycardia
Nitroglycerin