A rare case of myocardial bridge involving left anterior descending, obtuse marginal and ramus intermediate coronary arteries

Abstract

Myocardial bridging, a congenital coronary anomaly, is a cluster of myocardial fibers crossing over the epicardial coronary arteries. It is most frequently seen in the left anterior descending artery (LAD), and rarely involves the circumflex (CX) and right coronary artery (RCA). We report a patient with an unusual coronary bridge crossing over the left anterior descending, obtuse marginal and ramus intermediate branches. The patient presented with exercise-induced angina pectoris that was relieved with medical therapy.

Multiple myocardial bridging in the elderly: A rare case

“…Kumar, et al [4] previously reported a case of myocardial bridging in 34-year-old Indian male, involving left main, LAD, left circumflex, and proximal major obtuse marginal branch. Kiris, et al [5] reported myocardial bridging involving the same combination as our patient, but in younger (46-year-old) Turkish male. This is the second reported case of myocardial bridging involving LAD, ramus intermedius, and OM1.…”

Assessment of Clinical Features and Morphological Characteristics of Myocardial Bridging Involving the Left Circumflex Artery Using Coronary Computed Tomography Angiography

“…However, very few original papers mentioned MB of the LCX artery, but did not describe it in detail [20][21][22][23][24][25][26]. Furthermore, several researchers have reported case reports stating the characteristics of MB of the LCX artery [7][8][9][10][11][12][13][14]. Even though most MBs are considered congenital and asymptomatic, most cases have reported that patients with MB of the LCX artery experienced severe and chronic chest pain [7][8][9][11][12][13][14].…”

“…Furthermore, several researchers have reported case reports stating the characteristics of MB of the LCX artery [7][8][9][10][11][12][13][14]. Even though most MBs are considered congenital and asymptomatic, most cases have reported that patients with MB of the LCX artery experienced severe and chronic chest pain [7][8][9][11][12][13][14]. In 2005, Gunduz et al rst described a case of myocardial infarction in the rst OM of the LCX artery [9].…”

“…Most MBs involve the left anterior descending (LAD) artery, followed by the left circum ex (LCX) artery, right coronary artery (RCA), and other small branches, such as the diagonal artery, ramus intermedius artery, and obtuse marginal branch (OM) artery [5,6]. Multiple investigations have reported on the morphology and clinical features of MB located on the LAD artery; however, a few case reports have described symptomatic cases in which MB involved the LCX artery [7][8][9][10][11][12][13][14], and almost all of these patients underwent conventional coronary angiography. No studies describe the clinical features and morphological characteristics of bridges in the LCX artery; especially the change of hemodynamics in the bridging segment.…”

Особливості Діагностики Пацієнтів Із Симптоматичними Тунельованими Коронарними Артеріями

“…Вперше залягання епікардіальної вінцевої артерії в м'язовому сегменті описав Рейман у 1737 році, назвавши м'язовий сегмент місточком, а артерію, розташовану в його межах, тунельованою (пірнаючою). Частота виявлення цієї аномалії при патологоанатомічному дослідженні становить 7-85% випадків, що значно відрізняється від ангіографічних знахідок, які варіюють від 0,5 до 4,5% [1][2][3][4][5][6][7][8][9][10]. Ці факти свідчать про труднощі прижиттєвої діагностики ТКА, визначаючи актуальність вивчення і необхідність розробки алгоритмів діагностики та лікування хворих із цією аномалією.…”