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Symptomatic myocardial bridging in a child without hypertrophic cardiomyopathy

Muhannad Daana1, Isaiah Wexler, Eli Milgalter

  • 1Department of Pediatrics-Mount Scopus, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Pediatrics
|January 5, 2006
PubMed

Insights

Myocardial bridging (MB) in children can cause cardiac ischemia and syncope, even without ventricular hypertrophy. Surgical unroofing offers a complete recovery for this rare coronary anomaly.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Coronary Artery Anomalies

Background:

  • Myocardial bridging (MB) is a rare congenital coronary anomaly.
  • It is often associated with hypertrophic cardiomyopathy or left ventricular hypertrophy in children.
  • Previous studies, primarily in adults, suggest a link between MB and sudden cardiac death or ischemia.

Observation:

  • This report details an 11-year-old girl presenting with syncope and ischemic symptoms.
  • The symptoms were associated with myocardial bridging of the left anterior descending artery's middle segment.
  • Notably, the coronary anomaly was not accompanied by left ventricular hypertrophy.

Findings:

  • The patient experienced syncope and cardiac ischemia due to myocardial bridging.
  • The absence of left ventricular hypertrophy in this case challenges typical associations.
  • Surgical unroofing of the affected coronary artery segment led to complete resolution of symptoms.

Implications:

  • Myocardial bridging should be considered in the differential diagnosis of pediatric syncope and ischemia.
  • The diagnosis is important even when left ventricular hypertrophy is absent.
  • Early diagnosis and surgical intervention can prevent adverse cardiac events in affected children.

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