Extensive Myocardial Bridging Treated with CABG
Jerry Fan1, Corry Sanford1, Syed Zamin2
1Cardiology Baylor Scott and White Health - Temple.
Insights
Myocardial bridging, often benign, can cause serious heart issues. Coronary artery bypass grafting effectively treated a patient with severe symptoms from this condition.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Myocardial bridging, typically affecting the left anterior descending artery, is usually benign.
- Significant systolic compression can lead to myocardial ischemia, coronary artery spasm, and arrhythmias.
Observation:
- Refractory anginal symptoms in a patient with myocardial bridging were observed.
- Medical management with beta-blockers and calcium channel blockers proved insufficient.
Findings:
- Surgical intervention with coronary artery bypass grafting (CABG) was performed for refractory symptoms.
- CABG successfully relieved the patient's anginal symptoms.
Implications:
- Coronary artery bypass grafting is a viable option for managing severe myocardial bridging.
- Careful consideration of long-term outcomes is crucial for surgical decisions in young, healthy patients.
Abstract:
Myocardial bridging is generally considered a benign condition, however with significant systolic compression can cause ischemia, spasm, or malignant arrhythmias. Generally, myocardial bridging occurs in the left anterior descending artery in approximately 80% of cases. First-line therapy includes beta-blockers and calcium channel blockers but refractory cases usually requires surgical intervention with myotomy or coronary artery bypass grafting. The decision to undergo surgical management of myocardial bridging is difficult as many of these patients are young and otherwise healthy therefore long-term outcomes of surgical intervention should be considered carefully prior to pursuing surgical management. We present a case of refractory anginal symptoms relieved with coronary artery bypass grafting.
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