320-row-detector CT angiography findings in a case with myocardial bridging in the three main coronary arteries.

Abstract

A 46-year-old man with the complaining of palpitation was admitted to our hospital. Polymorphic ventricular early beats were observed on electro cardiography, The patient was referred to our department for coronary artery computed tomography angiography (CTA) for a probable congenital anomaly. On coronary CTA performed by a 320-Row-Detector scanner; left main coronary artery was short. The myocardial bridging (MB) causes approximately 75% luminal stenosis in a 2.5-cm segment was observed in the middle segment of left anterior descending artery (Fig. A, white arrow). The circumflex artery was continuing as the first obtus margin artery and this branch was separating to four branches in the middle part. All of these branches were coursing subepicardially in the middle and distal part (Fig. B, white arrowheads). The right main coronary artery was separating to two branches in the proximal part, and the thinner one was showing MB in its middle part (Fig. C, black arrow). This branch had a subepicardial course as well, in its distal part along the right atrium (Fig. C, black arrowheads). Eventually, all the cardiologic examinations and imaging findings were reevaluated. Based on those findings, antiarrhythmic drug therapy was prescribed by cardiology department, and the patient was called for regular follow-up.