Progression of the milking effect of the coronary artery

Myocardial bridging and systolic milking may be involved in myocardial ischemia, myocardial infarction, and sudden death. We describe a patient whose milking effect progressed significantly over a two-year period. We conclude that bridging and milking effect can progress over a relatively short period. In those patients with prior reports of insignificant bridging and milking on coronary arteriograms and continued angina-like chest pain, a repeated catheterization may be warranted.