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Myocardial bridging phenomenon is not invariable: A case report

Hao-Hao Li1, Ming-Wang Liu2, Yang-Fang Zhang2

  • 1Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China.

World Journal of Clinical Cases
|October 31, 2022
PubMed

Insights

Myocardial bridging, a common condition, typically shows a consistent milking effect. However, this case reveals the milking effect can change, suggesting variability and potential autonomic nervous system involvement.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Anatomical Pathology

Background:

  • Myocardial bridging is a frequent congenital heart anomaly.
  • The associated 'milking effect' on coronary angiography is usually considered static.
  • This case challenges the traditional view of myocardial bridging's fixed nature.

Observation:

  • A 63-year-old male presented with ST-segment elevation myocardial infarction.
  • Initial coronary angiography revealed a severe milking effect in the left anterior descending artery.
  • Follow-up angiography demonstrated significant alleviation of the milking effect.

Findings:

  • The observed dynamic change in the milking effect is exceptionally rare.
  • This variability suggests limitations in diagnosing myocardial bridging solely via angiography.
  • The phenomenon's variability may impact prognostic assessments.

Implications:

  • Myocardial bridging is not invariably static and can fluctuate.
  • The autonomic nervous system's role in modulating the milking effect warrants further investigation.
  • Coronary angiography's diagnostic and prognostic capabilities for myocardial bridging may be limited.
Abstract

Keywords:
Autonomic nervous systemCase reportCoronary angiographyEndocrine systemMilking effectMyocardial bridging

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