Vigorous Vascular Contraction Mimicking Myocardial Bridge Resulting from Digoxin Treatment in an Elderly Patient

Abstract

Myocardial bridge is defined as the intramyocardial course of a segment of a coronary artery. Digoxin increases the force of myocardial contraction, which augments the compression of the vessel. An 86-year-old woman was admitted to hospital because of chest tightness on exertion. Coronary angiography showed a myocardial bridge in the left anterior descending coronary artery that was absent 6 years previously. There was >80% reduction in the minimal luminal diameter during systole. Digoxin was discontinued. Repeat coronary angiography performed approximately 4 months later revealed that systolic compression of the myocardial bridge had decreased significantly, and the reduction was <20%. Digoxin treatment resulted in vigorous vascular contraction in this octogenarian.

Keywords

• digoxin
• elderly
• myocardial bridge
• vigorous vascular contraction