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Epicardial fibrosis mimicking a myocardial bridge

Konstantinos Dean Boudoulas1, Ahmet Kilic2

  • 1Division of Cardiovascular Medicine, Department of Medicine, The Ohio State University Medical Center, Columbus, OH, USA kdboudoulas@osumc.edu.

Interactive Cardiovascular and Thoracic Surgery
|May 20, 2014
PubMed

Insights

Myocardial bridges can compress coronary arteries. However, this case revealed fibrotic tissue, not a myocardial bridge, causing coronary artery compression and myocardial infarction, highlighting fibrosis as a differential diagnosis.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Pathology

Background:

  • Coronary artery compression during systole is often attributed to myocardial bridges, where arteries tunnel within the heart muscle.
  • Myocardial bridges are a known cause of myocardial ischemia and infarction.

Observation:

  • A 49-year-old man experienced acute anterior wall myocardial infarction.
  • Coronary arteriography suggested a myocardial bridge as the cause.
  • Surgical exploration revealed the left anterior descending artery had a normal epicardial course, with no intramyocardial segment.

Findings:

  • Coronary artery compression was caused by overlying fibrotic tissue, not a myocardial bridge.
  • The fibrotic tissue was successfully excised.

Implications:

  • Epicardial coronary artery fibrosis should be considered in the differential diagnosis of coronary artery compression.
  • This finding expands the understanding of non-myocardial bridge causes of coronary artery compression and myocardial infarction.

Keywords:
Acute myocardial infarctionArtery compressionFibrosis

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