Abnormal ventricular repolarisation in association with myocardial bridging

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Medical Imaging

Background:

• Myocardial bridging is an anatomical variation where a segment of epicardial coronary artery runs intramyurally.
• Systolic compression of coronary arteries by myocardial bridges is typically an incidental finding during coronary arteriography.
• Myocardial bridging is infrequently associated with myocardial ischemia.

Observation:

• A young male patient presented with chest pain and significant ventricular repolarization abnormalities.
• Initial clinical presentation suggested myocardial infarction.
• Cardiac catheterization revealed a normal coronary artery tree except for a myocardial bridge compressing a major diagonal branch of the left anterior descending artery.

Findings:

• The patient's myocardial bridging was identified as the cause of his symptoms.
• Echocardiography showed no signs of hypertrophic cardiomyopathy.
• The case demonstrates a rare symptomatic presentation of myocardial bridging.

Implications:

• This case underscores the importance of considering myocardial bridging in the differential diagnosis of unexplained chest pain, especially in younger individuals.
• It highlights the potential for myocardial bridging to cause significant ischemic symptoms despite its common incidental nature.
• Further investigation into the functional significance of myocardial bridging in symptomatic patients is warranted.