Nonsymptomatic myocardial bridge causing systolic total narrowing of circumflex artery

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Interventional Cardiology

Background:

• Myocardial bridging involves dynamic narrowing of coronary arteries during systole.
• While common in the left anterior descending artery, it is rare in the left circumflex artery.

Purpose of the Study:

• To report a rare case of symptomatic myocardial bridge in the left circumflex artery.
• To illustrate the diagnostic and management approach for this uncommon condition.

Main Methods:

• Clinical presentation of a 62-year-old male with severe chest pain.
• Electrocardiogram findings: T wave inversion and ST depression.
• Coronary angiography revealing a complicated lesion and a myocardial bridge with 100% systolic narrowing of a left circumflex artery branch.

Main Results:

• Successful stenting of the left anterior descending artery lesion.
• Identification and management of a rare myocardial bridge in the left circumflex artery.
• Patient discharged on beta-blocker therapy with no recurrent chest pain at six months.

Conclusions:

• Myocardial bridges in the left circumflex artery, though rare, can cause significant ischemic symptoms.
• Multimodality imaging and intervention are crucial for managing such cases.
• Conservative management with beta-blockers can be effective post-intervention.