Association of Myocardial Bridge and Takotsubo Cardiomyopathy: A Case Report and Literature Review

A woman presented with chest pain following emotional stress. Investigations showed acute ST-segment elevation, myocardial infarction, and elevated serum troponin. Emergency heart catheterization showed left anterior descending artery myocardial bridging, apical ballooning consistent with takotsubo cardiomyopathy (TTC), and decreased ejection fraction. Two days later, echocardiogram demonstrated near normalization of ventricular function. The etiology of TTC is not known but may include a stress-related surge of catecholamines or epicardial coronary spasm. Other case series reported an association of myocardial bridge and TTC. Catecholamines surge during stress might contribute to both diseases resulting in an apparent association; alternatively, a symptomatic myocardial bridge may be a contributing factor in worsening TTC.