Myocardial Bridging Presenting With Ventricular Tachycardia and Non-ST-Segment Elevation Myocardial Infarction
Justin L Devera1, Ezra A Amsterdam1
1University of California-Davis, Division of Cardiovascular Medicine, Davis, California, USA.
JACC. Case Reports
|February 20, 2025
Summary
Myocardial bridging, a condition where heart muscle covers a coronary artery, can cause serious cardiac events like heart attacks and ventricular tachycardia. Early treatment can lead to symptom improvement and better heart function.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Clinical Case Study
Background:
- Myocardial bridging is a congenital anomaly where a segment of a coronary artery travels through the heart muscle.
- It can lead to myocardial ischemia, arrhythmias, and sudden cardiac death.
- This case presents a complex manifestation of myocardial bridging.
Purpose of the Study:
- To report a case of myocardial bridging presenting with acute chest pain, ventricular tachycardia, and myocardial infarction.
- To illustrate the diagnostic process and management of myocardial bridging.
- To emphasize the potential for major adverse cardiovascular events associated with myocardial bridging.
Main Methods:
- A 46-year-old male patient with acute chest pain underwent coronary angiography.
- Diagnostic evaluation included electrocardiography and echocardiography.
- Treatment involved antiplatelet therapy and guideline-directed medical therapy for heart failure.
Main Results:
- Coronary angiography revealed myocardial bridging of the mid left anterior descending coronary artery.
- The patient experienced monomorphic ventricular tachycardia and non-ST-segment elevation myocardial infarction.
- One month post-treatment, symptoms improved, and left ventricular ejection fraction showed recovery.
Conclusions:
- Myocardial bridging can present with diverse and severe cardiovascular manifestations.
- Prompt diagnosis and appropriate medical management are crucial for improving outcomes.
- This case underscores the importance of considering myocardial bridging in patients with unexplained cardiac events.
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