Myocardial bridging causing transmural ischemia Successful coronary artery bypass surgery

被引:5
作者
Vianna, Caio B. [1 ]
Gonzalez, Maria M. [1 ]
Jatene, Fabio B. [1 ]
Gama, Marcus N. [1 ]
Timerman, Sergio [1 ]
Cesar, Luiz A. [1 ]
机构
[1] Univ Sao Paulo, Sch Med, Heart Inst InCor, BR-05508 Sao Paulo, Brazil
关键词
Myocardial bridging; Ischemia; Coronary vasospasm; Coronary artery bypass; Intravascular ultrasound;
D O I
10.1016/j.ijcard.2006.07.159
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Myocardial bridging is a common and usually benign inborn coronary anomaly. We report on a 51-year-old man who presented with recent angina on minimum physical effort. Cineangiography showed myocardial bridging of the mid-left anterior descending artery (LAD), and intracoronary ultrasonography excluded atherosclerotic disease. Gated single-photon emission computed tomography (SPECT), with exercise stress, showed an extensive anterior perfusion defect, and remarkable ST-segment elevation (up to 10 mm) in recovery. Vasospasm of the LAD was the main hypothesis. Additional oral drugs did not bring about improvement, as indicated on a new SPECT; disabling angina persisted. Surgical revascularization of the LAD by left internal mammary artery graft was performed. Two years later, SPECT and exercise tests returned to normal. The patient remains asymptomatic. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:E49 / E51
页数:3
相关论文
共 8 条
[1]   Myocardial bridging [J].
Alegria, JR ;
Herrmann, J ;
Holmes, DR ;
Lerman, A ;
Rihal, CS .
EUROPEAN HEART JOURNAL, 2005, 26 (12) :1159-1168
[2]   VASOSPASTIC CORONARY-OCCLUSION ASSOCIATED WITH A MYOCARDIAL BRIDGE [J].
CIAMPRICOTTI, R ;
ELGAMAL, M .
CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS, 1988, 14 (02) :118-120
[3]   New signs characteristic of myocardial bridging demonstrated by intracoronary ultrasound and Doppler [J].
Ge, J ;
Jeremias, A ;
Rupp, A ;
Abels, M ;
Baumgart, D ;
Liu, F ;
Haude, M ;
Görge, G ;
von Birgelen, C ;
Sack, S ;
Erbel, R .
EUROPEAN HEART JOURNAL, 1999, 20 (23) :1707-1716
[4]   Long term angiographic and clinical follow up in patients with stent implantation for symptomatic myocardial bridging [J].
Haager, PK ;
Schwarz, ER ;
vom Dahl, J ;
Klues, HG ;
Raffelmann, T ;
Hanrath, P .
HEART, 2000, 84 (04) :403-408
[5]  
Kodama K, 1998, ANGIOLOGY, V49, P659
[6]   Bridge over troubling spasm: Is the association of myocardial bridging and coronary artery spasm a distinct entity? Three case reports [J].
Low, AF ;
Chia, BL ;
Ng, WL ;
Lim, YT .
ANGIOLOGY, 2004, 55 (02) :217-220
[7]  
Pratt J W, 1999, Heart Surg Forum, V2, P250
[8]   Myocardial bridging increases the risk of coronary spasm [J].
Teragawa, H ;
Fukuda, Y ;
Matsuda, K ;
Hirao, H ;
Higashi, Y ;
Yamagata, T ;
Oshima, T ;
Matsuura, H ;
Chayama, K .
CLINICAL CARDIOLOGY, 2003, 26 (08) :377-383