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Complications associated with myocardial bridging in four children without underlying cardiac disease: a case series

Federica Brancato1, Donato Rigante1,2, Marco Piastra2,3

  • 1Department of Life Sciences and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Paediatrics and International Child Health
|June 11, 2021
PubMed

Insights

Myocardial bridging, a coronary artery anomaly, can cause symptoms like chest pain and arrhythmias in children. This study highlights its potential to be symptomatic even without other heart conditions.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Anomalies
  • Cardiovascular Imaging

Background:

  • Myocardial bridging (MB) is a congenital coronary artery anomaly where a segment of the artery runs within the heart muscle.
  • Typically considered benign, MB can cause dynamic compression during systole.
  • Limited data exist on symptomatic MB in pediatric populations.

Observation:

  • Four children (6-13 years) presented to a pediatric emergency department with symptomatic MB.
  • Presentations included exertional chest pain and septic shock.
  • No other underlying cardiac abnormalities were identified in these patients.

Findings:

  • Computed tomography (CT) confirmed MB of the left anterior descending (LAD) coronary artery branches in three patients.
  • Two-year follow-up was uneventful for these three.
  • The fourth patient experienced ventricular fibrillation and autopsy revealed a significant intramyocardial LAD tract.

Implications:

  • Symptomatic MB should be considered in the differential diagnosis for pediatric exertional chest pain.
  • MB can present with serious complications, including arrhythmias, in children.
  • Further investigation into pediatric MB is warranted to understand its clinical significance.
Abstract

Keywords:
Chest painmyocardial bridgingpaediatric cardiologypersonalised medicinetachycardia

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