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Updated: Aug 14, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Resolution of myocardial bridge-related wall motion abnormality and associated myocardial perfusion defect with
R Todd Hurst1, J Wells Askew, Richard Lee
1Department of Cardiovascular Diseases, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA.
Insights
Myocardial bridges can alter blood flow, causing symptoms or visible changes. This case shows a left anterior descending artery bridge linked to anterior wall issues, resolved by beta-blockers.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Medical Imaging
Background:
- Myocardial bridges are congenital anomalies where a segment of coronary artery travels through myocardium.
- They can cause myocardial ischemia due to dynamic compression during systole.
- Clinical presentation ranges from asymptomatic to angina, myocardial infarction, or arrhythmias.
Observation:
- A case of a myocardial bridge in the mid-left anterior descending artery is presented.
- The bridge was associated with anterior wall akinesis observed during left ventriculography.
- Gated cardiac single photon emission computed tomography revealed a fixed perfusion defect in the anterior wall.
Findings:
- The myocardial bridge caused significant hemodynamic alterations in coronary flow.
- Left ventriculography demonstrated anterior wall akinesis.
- Cardiac SPECT confirmed a fixed anterior wall perfusion defect, indicating chronic ischemia.
Implications:
- This case highlights the potential for myocardial bridges to cause significant left ventricular dysfunction.
- Beta-blocker therapy demonstrated efficacy in resolving the perfusion defect, suggesting a role in managing related ischemia.
- Noninvasive imaging modalities are crucial for diagnosing and assessing the impact of myocardial bridges.
Abstract:
While not uncommon, a myocardial bridge may result in significant alterations in coronary flow hemodynamics to the point of being either clinically evident based on symptoms, or visually apparent on noninvasive imaging modalities. We report a case of a myocardial bridge of the mid-left anterior descending artery associated with anterior wall akinesis on left ventriculography, and evidence of a fixed perfusion defect in the anterior wall by gated cardiac single photon emission computed tomography that resolved with initiation of beta-blocker therapy.
