Myocardial Bridging, Unusual Cause of Myocardial Infarction; Case Report and Review of Literature

Abstract

ABSTRACT Myocardial bridging is a common coronary anomaly. Although it is considered to be a benign condition, it can rarely be complicated by myocardial infarction. Clinicians should be suspicious of myocardial bridging as an etiology of myocardial infarction when other more common etiologies have been excluded. High resolution CT angiography is the gold standard for diagnostic evaluation, with the length and depth of the bridge, and response to conservative therapies guiding clinical decision making on surgical correction. Myocardial bridging is a congenital coronary anomaly in which the coronary arteries pass through the heart muscle rather than lying on its surface. It is typically a benign condition, and most patients are asymptomatic. However, some may experience symptoms of angina. In rare cases, patients can present with myocardial ischemia or infarction. In this report, we present the case of a 38‐year‐old female who presented with a 2‐month history of chest pain. Further evaluation with coronary computed tomography angiography (CCTA) revealed myocardial bridging. Subsequently, she developed a myocardial infarction, a rare complication of this condition. We discuss this uncommon complication of a common anomaly.

Keywords

• chest pain
• coronary anomaly
• myocardial bridging
• myocardial infarction
• myocardial ischemia