J Lipid Atheroscler.  2015 Dec;4(2):137-140. 10.12997/jla.2015.4.2.137.

Myocardial Ischemia by Aggravation of Myocardial Bridging

• Kim KU
• Choi JK
• Oh HM
• Woo JY
• Park HS
• Moon SY
• Seo WW
• Han KR

• KMID: 2151822
• DOI: http://doi.org/10.12997/jla.2015.4.2.137

Abstract

Myocardial bridging (MB) occurs when the myocardium covers a segment of a major epicardial coronary artery, resulting in a tunneled arterial segment. Although MB is generally considered benign, it has been associated with myocardial ischemia. A 70-year-old man with MB (50% luminal narrowing during systole) at the mid-left anterior descending artery (LAD) on previous coronary angiography (CAG) visited our hospital with worsening chest pain. His blood pressure (BP) was not well controlled because of poor compliance. Follow-up CAG showed that MB at the mid-LAD progressed to severe stenosis (>90% luminal narrowing during systole) and the total length of tunneled artery extended from 22.5 to 23.9 mm. His chest pain was relieved by BP control. This is the first report of myocardial ischemia secondary to progression of MB demonstrated by CAG in Korea.

Keyword

Myocardial bridge; Ischemia; Hypertension

MeSH Terms

Aged
Arteries
Blood Pressure
Chest Pain
Compliance
Constriction, Pathologic
Coronary Angiography
Coronary Vessels
Follow-Up Studies
Humans
Hypertension
Ischemia
Korea
Myocardial Bridging*
Myocardial Ischemia*
Myocardium
Phenobarbital
Phenobarbital

Figure

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  Fig. 1 Coronary angiography of the left anterior descending artery (LAD) in 2006. (A) Moderate systolic stenosis (50% luminal narrowing) was observed at end-systole, and the total length of the bridged segment was 22.5 mm (arrow). (B) The LAD at end-diastole showed no obvious stenotic lesion.

• 

  Fig. 2 Coronary angiography of the left anterior descending artery (LAD) in 2014. (A) Severe systolic stenosis (>90% luminal narrowing) was observed at end-systole, and the total length of the bridged segment was 23.9 mm (arrow). (B) The LAD at end-diastole showed no obvious stenotic lesion.

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