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Myocardial Bridge or Something Else?

Xiaobin Wang1, Hassan Rastegar2, Ethan J Rowin3

  • 1Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, 800 Washington Street, Boston, MA 02111.

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|September 3, 2021
PubMed
Summary
This summary is machine-generated.

This case study highlights myocardial bridges (MB) in hypertrophic cardiomyopathy (HCM). Recognizing HCM variants is crucial for identifying latent outflow tract obstruction, even without significant septal hypertrophy.

Keywords:
hypertrophic cardiomyopathymyocardial bridgestress echocardiographytransesophageal echocardiography

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Myocardial bridges (MB) are common in hypertrophic cardiomyopathy (HCM).
  • HCM presents with diverse phenotypes, complicating the diagnosis of latent left ventricular outflow tract obstruction.
  • Exertional dyspnea and angina can be symptoms of underlying cardiac conditions.

Purpose of the Study:

  • To report a case of myocardial bridge (MB) requiring surgical unroofing.
  • To discuss the association between MB and hypertrophic cardiomyopathy (HCM).
  • To emphasize the importance of identifying phenotypic variants of HCM for diagnosing outflow tract obstruction.

Main Methods:

  • Intraoperative transesophageal echocardiography.
  • Provocative maneuvers during echocardiography.
  • Surgical unroofing of myocardial bridge.

Main Results:

  • Systolic anterior motion of the mitral valve with septal contact was observed.
  • Left ventricular outflow tract obstruction was identified.
  • Obstruction occurred despite the absence of significant basal septal hypertrophy.

Conclusions:

  • Myocardial bridges can be associated with hypertrophic cardiomyopathy.
  • Recognizing diverse HCM phenotypes is essential for diagnosing outflow tract obstruction.
  • A high index of suspicion is necessary for identifying latent obstruction in HCM patients.