Case Report

Alarming ST-Segment Elevation in a Young Male with Left Anterior Descending Coronary Artery Myocardial Bridging

Authors: Nirav A. Patel, MBBS, Molly Szerlip, MD, Dineshkumar Patel, MBBS, Deepak Kapoor, MD

Abstract

Chest pain continues to be one of the leading emergency department presentations. Acute coronary syndrome is the most dreaded chest pain scenario, as “time is myocardium” in this situation. Numerous benign and less life-threatening diseases like early repolarization, acute pericarditis, and vasospastic angina can present with a similar clinical picture. ST-segment elevation on an electrocardiogram can occur in all these situations and in many others, creating diagnostic dilemma. A young male with chest pain and concurrent ST-segment elevation was reported. He was ultimately discovered to have myocardial bridging of a coronary arterial segment.


Key Points


* Electrocardiogram is not a perfect test; it serves as an aide to clinical symptomatology.


* Early repolarization and acute pericarditis can create electrocardiographic diagnostic difficulties for acute myocardial infarction.


* Myocardial bridging, usually considered a benign anomaly, can be associated with myocardial ischemia.

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