To the Editor. We report the case of patient P.R., a 46-year-old man with an echocardiographic diagnosis of nonobstructive hypertrophic cardiomyopathy since 2001. The patient’s major cardiovascular risk factors were a familial history of coronary artery disease and mild hypertension. In the previous 6 months, the patient complained of dyspnea on exertion (NYHA II), tachycardia and typical angina. An exercise stress test and subsequent physical stress echocardiography were completely negative. Due to the worsening of the symptoms at rest, we decided to perform selective coronary angiography. An 80% stenosis was detected in the proximal tract of the left anterior descending artery (LAD), at the level of the origin of the first diagonal branch. Three centimeters distal to this lesion, in the middle segment of the LAD, a clear dynamic (systolic) narrowing of the coronary arterial lumen was detected, suggesting a myocardial bridge (Fig. 1). This finding was confirmed by performing an intravascular ultrasound (IVUS) examination (Fig. 2).