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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
Summary
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.
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