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Extremely Deep Myocardial Bridge With Fixed-Like Coronary Stenosis
Liuyang Tian1, Xiuru Yang2, Yizhen Yang1
1Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Image(S):
Electrocardiography, coronary computed tomography angiography, coronary angiography, and intravascular ultrasound (IVUS) findings in an extremely deep left anterior descending myocardial bridge.
Case Summary:
A 56-year-old woman had exertional chest pain with transient anterior ST-segment elevation. Coronary computed tomography angiography showed a 7.5-mm-deep mid-left anterior descending bridge. Angiography showed persistent narrowing without a milking effect. IVUS demonstrated a perimedial high-echoic band and bilateral perimedial high-echogenicity, supporting persistent compression. Surgical unroofing was considered high risk, and conservative therapy was chosen.
Take-Home Messages:
Deep myocardial bridging can mimic fixed stenosis. IVUS can help identify persistent compression in atypical bridged segments.
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