Case Report

Unappreciable Myocardial Bridge Causing Anterior Myocardial Infarction and Postinfarction Angina

Authors: José Diaz-Widmann, MD, S. Lane Cox, MD, Chanwit Roongsritong, MD, FACC

Abstract

We report a case of anterior myocardial infarction in a middle-aged man without risk factors for atherosclerosis in whom myocardial bridge was diagnosed several years later. An abnormal wall motion during acute myocardial infarction masked the characteristic angiographic findings of myocardial bridge and rendered it unappreciable during the initial angiographic study.

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References

  1. Antman EM, Braunwald E. Acute myocardial infarction, in Braunwald E, Zipes DP, Libby P (eds): Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, W.B. Saunders, 2001, ed 6, pp 1114–1218.
  2. Laifer LI, Weiner BH. Percutaneous transluminal coronary angioplasty of a coronary artery stenosis at the site of myocardial bridging. Cardiology 1991; 79: 245–248.
  3. Vasan RS, Bahl VK, Rajani M. Myocardial infarction associated with a myocardial bridge. Int J Cardiol 1989; 25: 240–241.
  4. van Brussel BL, van Tellingen C, Ernst MP, Plokker HW. Myocardial bridging: A cause of myocardial infarction? Int J Cardiol 1984; 6: 78–82.
  5. Ciampricotti R, el Gamal M. Vasospastic coronary occlusion associated with a myocardial bridge. Cathet Cardiovasc Diagn 1988; 14: 118–120.
  6. Ramos SG, Montenegro AP, Felix PR, Kazava DK, Rossi MA. Occlusive thrombosis in myocardial bridging. Am Heart J 1993; 125: 1771–1773.
  7. Ishimori T, Raizner AE, Chahine RA, Awdeh M, Luchi RJ. Myocardial bridges in man: Clinical correlations and angiographic accentuation with nitroglycerin. Cathet Cardiovasc Diagn 1977; 3: 59–65.
  8. Schwarz ER, Klues HG, vom Dahl J, Klein I, Krebs W, Hanrath P. Functional, angiographic and intracoronary Doppler flow characteristics in symptomatic patients with myocardial bridging: Effect of short-term intravenous &bgr;-blocker medication. J Am Coll Cardiol 1996; 27: 1637–1645.
  9. Irvin RG. The angiographic prevalence of myocardial bridging in man. Chest 1982; 81: 198–202.
  10. Mohiddin SA, Begley D, Shih J, Fananapazir L. Myocardial bridging does not predict sudden death in children with hypertrophic cardiomyopathy but is associated with more severe cardiac disease. J Am Coll Cardiol 2000; 36: 2270–2278.
  11. Ge J, Erbel R, Rupprecht HJ, Koch L, Kearney P, Gorge G, et al. Comparison of intravascular ultrasound and angiography in the assessment of myocardial bridging. Circulation 1994; 89: 1725–1732.