Myocardial bridging with left ventricular hypertrophy presenting as Wellens pattern

Area of Science:

• Cardiology
• Cardiac Surgery
• Clinical Medicine

Background:

• Myocardial bridging (MB) is an anomaly where epicardial coronary arteries traverse myocardial tissue.
• While often benign, severe MB can significantly impair quality of life due to anginal symptoms.
• Diagnosis and management of symptomatic MB can be complex.

Observation:

• This report details a case of severe myocardial bridging.
• The patient presented with symptoms indicative of the Wellens pattern, a specific ECG finding.
• The case also involved underlying left ventricular hypertrophy (LVH).

Findings:

• Severe myocardial bridging can mimic acute coronary syndromes.
• The Wellens pattern in this context suggests significant coronary artery compromise.
• Left ventricular hypertrophy may coexist with and potentially exacerbate symptoms of myocardial bridging.

Implications:

• Accurate diagnosis of severe MB is crucial for appropriate patient management.
• Treatment strategies for MB range from medical therapy to surgical intervention.
• Percutaneous coronary intervention (PCI) has a limited role in managing severe myocardial bridging.