Myocardial Bridging as a Differential Diagnosis for Myocardial Infarction: A Case Report
Carter Gay1, Colby Kihara1, Arsh N Patel1
1Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.
Cureus
|May 11, 2023
Summary
Myocardial bridging, a condition where a heart artery segment is covered by muscle, can cause serious cardiac events like ischemia and infarction. This case highlights that myocardial bridging is not always benign and requires careful consideration in patients with chest pain.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Clinical Case Reports
Background:
- Myocardial bridging is a congenital anomaly where a segment of a coronary artery travels through the heart muscle.
- Traditionally considered a benign condition, its role in causing myocardial ischemia is increasingly recognized.
Observation:
- A 55-year-old male presented with acute chest pain and ST-segment elevation on ECG.
- Cardiac catheterization revealed myocardial bridging of the left anterior descending artery.
- No obstructive coronary artery disease was found.
Findings:
- Myocardial bridging, in this case, was associated with symptoms and ECG changes suggestive of ischemia.
- The bridging segment did not show significant stenosis but was implicated in the acute cardiac event.
Implications:
- This case underscores that myocardial bridging can be a cause of myocardial ischemia and infarction.
- Clinicians should consider myocardial bridging in the differential diagnosis of patients with unexplained chest pain and ischemic ECG changes.
- Further research is warranted to understand the mechanisms and long-term risks associated with myocardial bridging.
Keywords:
coronary angiographymyocardial bridgingmyocardial infarctionmyocardial ischemiast-segment elevationMore Related Videos
Related Concept Videos
Myocarditis II: Clinical Features and Diagnostic Tests
13
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
13
Myocarditis I: Introduction
12
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
12
Acute Coronary Syndrome I: Introduction
33
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
33
Acute Coronary Syndrome III: Diagnostic Studies
13
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
13
Mitral Stenosis II: Clinical features and Diagnostic Tests
26
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
26
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
24
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
24


