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Milking-like effect secondary to systolic expansion of a post-infarction left ventricular aneurysm

Raúl Moreno1, Jesús Perez del Todo, Carlos Macaya

  • 1Division of Interventional Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain. raulmorenog@terra.es

The Journal of Invasive Cardiology
|October 2, 2003
PubMed

Insights

Myocardial bridging causes systolic compression in coronary arteries. This case study highlights a milking effect in the left anterior descending artery of a patient with a left ventricular aneurysm after a heart attack.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Interventional Cardiology

Background:

  • Myocardial bridging is a congenital anomaly where a segment of a coronary artery tunneled within the heart muscle.
  • It can lead to dynamic obstruction, particularly during systole, mimicking other coronary pathologies.
  • Left ventricular aneurysms post-myocardial infarction represent significant cardiac remodeling and risk.

Observation:

  • Coronary angiography revealed a unique milking-like effect.
  • Systolic compression was noted in the distal left anterior descending coronary artery.
  • The patient had a history of myocardial infarction and a resultant left ventricular aneurysm.

Findings:

  • The observed systolic compression of the distal left anterior descending artery was attributed to myocardial bridging.
  • This finding is unusual given the location and context of a post-infarction left ventricular aneurysm.
  • The milking effect suggests significant dynamic obstruction during the cardiac cycle.

Implications:

  • This case expands the understanding of myocardial bridging manifestations.
  • It underscores the importance of considering dynamic coronary compression in complex cardiac conditions.
  • Further research may explore the impact of myocardial bridging on aneurysm healing and progression.

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