Cardiologie clinique et expérimentale
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Myocardial Bridge Syndrome: A Case Report and Literature Review

Mei-Lian Cai Wei Zhang

Background: Myocardial Bridging (MB) is a congenital coronary artery malformation. Various clinical symptoms related to MB have been reported; however, subxiphoid pain has rarely been reported. Moreover, it is rarer for Electrocardiography (ECG) to show such obvious ischemia in patients with MB.

Case presentation: We report a 36-year-old male who presented with subxiphoid pain. ECG showed ST segment depression and T-wave inversion with symmetry in leads V2 to V6. Emergency Coronary Angiography (CAG) confirmed that it was caused by MB.

Results: CAG showed MB of the Left Anterior Descending (LAD) artery with a 1.5 cm intramural segment and that the vascular lumen was compressed 80% during systole. At the same time, gastroscopy showed peripyloric and antral ulcers. The patient received Calcium Channel Blockers (CCBs) and drug treatment for peptic ulcers, and then the symptoms disappeared.

Conclusion: ECG showed obvious myocardial ischemia. MB may have been one of the reasons for ischemia. When the heart contracts, the myocardial bridge compress the mural coronary artery and further narrows its lumen. The longer and thicker the myocardial bridge is, the greater the angle between the myocardial fibers and blood vessels the more severe the mural coronary artery stenosis is, the more severe the distal myocardial ischemia.