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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
PubMed

Insights

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.

Keywords:
acute coronary syndromecongenital heart defectcoronary vessel anomalymyocardial infarctionsystolic heart failureventricular tachycardia

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