Bridging the Gap in a Rare Cause of Angina

Khadke, Sumanth; Vidovic, Jovana; Patel, Vinod F.

doi:10.15420/ecr.2020.33

Cited by 11 publications

(7 citation statements)

References 49 publications

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“…The characteristic image of deep MB was discovered to be coronary angiography with the "milking effect" caused by systolic compression of the tunneled segment (10). However, in individuals with thin bridges, the milking effect may be missed, and numerous novel imaging approaches have been developed to detect a bridge on morphological, hemodynamic, and functional evaluation (23)(24)(25)(26)(27)(28)(29)(30). The typical intravascular ultrasound (IVUS) finding is a "half-moon" sign, which represents an echolucent area present immediately adjacent to the vessel lumen that persists throughout the cardiac cycle and is demonstrated by Yamada et al to represent a muscle band overlying the tunneled arterial segment (29).…”

Section: Discussionmentioning

confidence: 99%

A bibliometric analysis on the progress of myocardial bridge from 1980 to 2022

Liang

et al. 2023

Front. Cardiovasc. Med.

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IntroductionAlthough the vast majority of patients with a myocardial bridge (MB) are asymptomatic, the anomaly was found to be associated with stable or unstable angina, vasospastic angina, acute coronary syndrome, and even malignant arrhythmias and sudden cardiac death in some cases.MethodsBy retrieving the relevant literature on MB from 1 January 1980 to 31 July 2022 from the Web of Science Core Collection (WoSCC) database, we used the bibliometric tools, including CiteSpace, VOS viewer, and alluvial generator, to visualize the scientific achievements on MB.ResultsA total of 630 articles were included. The number of published articles was in a fluctuating growth trend. These publications came from 37 contries, led by the USA and China. The leading country on MB was the United States, the leading position among institutions was Stanford University, and the most productive researcher on MB was Jennifer A. Tremmel. After analysis, the most common keywords were myocardial bridge, mortality, coronary angiography, descending coronary artery, and sudden death.ConclusionOur findings can aid researchers in understanding the current state of MB research and in choosing fresh lines of inquiry for forthcoming investigations. Prevalence and prognosis, mechanism atherosclerosis, hemodynamic significance, and molecular autops will likely become the focus of future research. In addition, more studies and cooperations are still needed worldwide.

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Section: Discussionmentioning

confidence: 99%

A bibliometric analysis on the progress of myocardial bridge from 1980 to 2022

Liang

et al. 2023

Front. Cardiovasc. Med.

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“…The extent and duration of compressed segments are clinically important because the compression may induce exertional chest pain, which may mimic the ACS manifestation. 3 Several modalities are available for assessing MB, whether non-invasive or invasive modalities. The non-invasive including multi-slice computed tomography (MSCT).…”

Section: Diagnosismentioning

confidence: 99%

“…2 MB patients might also present with more complicated cardiac events including acute coronary syndrome, coronary vasospasm, exercise-induced dysrhythmias, ventricular arrhythmias, or even sudden cardiac death. 3 The degree of hemodynamic impact depends on the thickness and length of the bridge, orientation of the bridge relative to myocardial fibers, and presence of loose connective tissue or adipose tissue around the bridged segment. 1 MB mostly diagnosed on MSCT or coronary angiography, with milking effect as a pathognomonic sign showing coronary compression by myocardium on systole and release of coronary artery during diastole.…”

Section: Introductionmentioning

confidence: 99%

Myocardial bridging manifested as acute coronary syndrome: an unusual presentation of the so-called benign coronary anatomy variant

Kartawan

Nurjanah²

2023

Int J Adv Med

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Myocardial bridging is an anatomical variant characterized by a coronary artery that tunneled through the myocardium. Often asymptomatic, myocardial bridging could also go to a further extent, presenting as myocardial ischemia in the form of stable angina pectoris, acute coronary syndrome, arrhythmias, or even sudden cardiac death. Although these are uncommon manifestations, it is still a challenge for physicians when encountering such cases. Additional imaging techniques are often required to diagnose myocardial bridging. This report is about a unique case of a 72-year-old man presenting with acute coronary syndrome (ACS) in the form of unstable angina pectoris (UAP), which was later found to be caused by myocardial bridging on coronary angiography. Following administration of beta-blocker, antiplatelet, and statin, the angina symptoms, as well as ischemic sign on electrocardiography (ECG), were completely resolved.

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“…On the other hand, the angiographic prevalence of MB was reported as 5% [18]. Although MB has been reported to be associated with acute coronary syndrome in many studies, no definite pathologic correlation between MB and acute coronary syndrome has been clearly established and it is generally considered a benign condition [19,20].…”

Section: Figure 2: Case Definitions Of Probable and Confirmed Myocard...mentioning

confidence: 99%

Myopericarditis After BNT162b2 mRNA Vaccination With Incidental Intramyocardial Bridging

Elghazal¹,

Alhudiri²,

Said³

et al. 2023

Cureus

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Myocarditis and pericarditis are inflammatory conditions affecting the myocardium and pericardium, respectively. They are caused by infectious and non-infectious conditions, including autoimmune disorders, drugs, and toxins. Vaccine-induced myocarditis has been reported with viral vaccines, including influenza and smallpox. The BNT162b2 mRNA vaccine (Pfizer-BioNTech) has shown great efficacy against symptomatic, severe coronavirus disease 2019 (COVID-19), hospital admissions, and deaths. The US FDA issued an emergency use authorization for the Pfizer-BioNTech COVID-19 mRNA vaccine for the prevention of COVID-19 in individuals ≥ five years. However, concerns were raised after reports of new cases of myocarditis following mRNA COVID-19 vaccines, especially among adolescents and young adults. Most cases developed symptoms after receiving the second dose. Here, we present a case of a previously healthy 34-year-old male who developed sudden and severe chest pain a week after the second dose of the Pfizer-BioNTech COVID-19 mRNA vaccine. Cardiac catheterization showed no angiographically obstructive coronary artery disease but it revealed intramyocardial bridging. This case report demonstrates that the mRNA COVID-19 vaccine can be associated with acute myopericarditis and the clinical presentation can mimic acute coronary syndrome. Despite that, acute myopericarditis associated with the mRNA COVID-19 vaccine is usually mild and can be managed conservatively. Incidental findings such as intramyocardial bridging should not exclude the diagnosis of myocarditis and should be carefully evaluated. COVID-19 infection has high mortality and morbidity even in young individuals, and all different COVID-19 vaccines were found effective in the prevention of severe COVID-19 infection and in decreasing COVID-19 mortality.

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Bridging the Gap in a Rare Cause of Angina

Cited by 11 publications

References 49 publications

A bibliometric analysis on the progress of myocardial bridge from 1980 to 2022

A bibliometric analysis on the progress of myocardial bridge from 1980 to 2022

Myocardial bridging manifested as acute coronary syndrome: an unusual presentation of the so-called benign coronary anatomy variant

Myopericarditis After BNT162b2 mRNA Vaccination With Incidental Intramyocardial Bridging

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