Three-vessel myocardial bridging: A possible cause of myocardial stunning

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Clinical Case Reports

Background:

• Myocardial bridging is a congenital anomaly where a segment of a coronary artery travels through the heart muscle.
• While common, bridging of all three major coronary arteries is exceptionally rare.

Observation:

• A rare case of myocardial bridging involving the left main, left anterior descending, and right coronary arteries is presented.
• The patient exhibited severe biventricular dysfunction and tachycardia, an unusual presentation.

Findings:

• Non-invasive multimodality cardiac imaging, including cardiac magnetic resonance (CMR), computed tomography angiography (CTA), and myocardial perfusion scintigraphy (MPS), was crucial for diagnosis.
• These imaging modalities enabled detailed visualization of the myocardial bridges and assessment of their functional impact.

Implications:

• This case underscores the importance of considering rare coronary anomalies in unexplained biventricular dysfunction.
• Successful management with targeted medical and neurohormonal therapy demonstrates a viable treatment approach for such complex cases.
• The findings contribute to understanding the clinical spectrum and diagnostic strategies for extensive myocardial bridging.