Myocardial bridge syndrome

Introduction: Myocardial bridge syndrome is characterized by intramyocardial paths of an epicardial coronary artery segment. This entity is present in approximately 20% of patients examined for coronary angiogram. The most common location is in the middle segment of the anterior interventricular artery. We present a patient of 45 years, smoking, with dyslipidemia, hypertension, retrosternal pain presenting for angina nature, variable duration, occurring mostly in conditions of moderate/big exercise and emotional overload. Methods: Clinical examination revealed grade II obesity, blood pressure 160/90 mm Hg, pulse 90 beats per minute regular. Biological register hypercholesterolemia with hypertriglyceridemia. The resting electrocardiogram revealed ischemic changes in the anterior circulation and registration for Holter ECG reveals frequent episodes of supraventricular tachycardia (freq uency max./min. 154/64 bpm), HR max. 1342 ms, max. 0.40 mV ST elevation, ST depression 0.32 mV max. Echocardiography fi nds: LV diastolic dysfunction with preserved systolic function and left ventricular hypertrophy. Coronary angiography revealed aspects of muscle bridge in the middle segment of the anterior interventricular artery. Myocardial scintigraphy examination reveals hipocaptare in third apical ventricular septum. Results: Hygienic-dietary therapy (stop smoking, salt restriction, hypolipidic) and medication (diuretics, calcium channel blockers, ACE inhibitors, statins, antiplatelet) evolution was favorable to relieve angina. Conclusions: The prognosis in patients with myocardial bridge syndrome without significant atherosclerotic lesions of epicardial coronary arteries is generally favorable, but the prognosis is influenced by the context in which the percentage of systolic compression goes over 75% of coronary diameter.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)