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Updated: Sep 30, 2026
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Postextrasystolic potentiation of vessel compression in myocardial bridging: detection by intravascular sonography
Holger Eggebrecht1, Clemens Von Birgelen, Junbo Ge
1Department of Cardiology, University Hospital of Essen, Hufelandstrasse 55, Germany.
Insights
This case study highlights myocardial bridging of the left anterior descending coronary artery (LAD). Intracoronary Doppler and intravascular sonography effectively identified this condition in a patient experiencing exertional chest pain.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Exertional chest pain can indicate underlying coronary artery disease.
- Myocardial bridging, where a segment of a coronary artery tunnels through heart muscle, can cause symptoms similar to angina.
Observation:
- A 67-year-old male presented with exertional chest pain.
- Coronary angiography identified myocardial bridging of the left anterior descending coronary artery (LAD) with systolic compression.
Findings:
- Intracoronary Doppler sonography revealed characteristic flow patterns in the LAD, including diastolic flow deceleration.
- Intravascular sonography demonstrated eccentric systolic compression, significantly worsened by an extrasystole.
Implications:
- Combined intracoronary Doppler and intravascular sonography are valuable tools for diagnosing myocardial bridging.
- Accurate diagnosis of myocardial bridging is crucial for managing patients with exertional chest pain.
Abstract:
We present the case of 67-year-old man with exertional chest pain. Coronary angiography revealed myocardial bridging of the left anterior descending coronary artery (LAD) with mild systolic vessel compression. An intracoronary Doppler sonographic examination of the LAD showed a fingertip-shaped antegrade flow pattern with a steep acceleration of coronary flow velocity during early diastole, followed by a steep deceleration and then a plateau in the coronary flow velocity during mid and late diastole. An intravascular sonographic examination using a 30-MHz transducer catheter showed eccentric vessel compression during systole and substantial augmentation of vessel compression after an incidental extrasystole. Both intracoronary Doppler sonography and intravascular sonography provided important information that helped us to identify myocardial bridging in this patient.
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