Abstract
Muscle overlying an intramyocardial segment of a coronary artery is termed a myocardial bridge. The intramyocardial segment, the tunneled artery, is compressed during systole. The condition is generally benign but may occasionally cause myocardial ischemia, infarction, arrhythmia, or sudden cardiac death. We present a case regarding a 52-year-old man with exercise-induced angina who was diagnosed with a myocardial bridge overlying the left anterior descending artery. He was initially treated with beta-blockers and later received coronary bypass graft surgery.
Highlights
The major coronary arteries are normally distributed epicardially, that is, on the surface of the myocardium
We present a case regarding a 52-year-old man with exercise-induced angina who was diagnosed with a myocardial bridge overlying the left anterior descending artery
To further examine the coronary anatomy, the patient underwent invasive coronary angiography, revealing a myocardial bridge confined to the left anterior descending artery (LAD) with mild systolic compression (Figure 1), which worsened during intravenous administration of nitroglycerin (Figure 2)
Summary
The major coronary arteries are normally distributed epicardially, that is, on the surface of the myocardium. These vessels have a segmental intramyocardial course. During systole, this segment is compressed either partially or completely. Muscle overlying the intramyocardial segment is called a myocardial bridge, and the artery coursing within the myocardium is termed a tunneled artery [1,2,3]
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