Multivessel myocardial bridge involving left and right coronary arteries

Abstract

A 62-year-old female patient with hypertension and a 4-month history of angina pectoris, triggered by emotional stress. The electrocardiogram showed left ventricular hypertrophy and changes in ventricular repolarization. The coronary angiography showed a significant left ventricular hypertrophy with no intracavitary gradient, and the presence of a myocardial bridge over the middle third of the left anterior descending artery and the right coronary artery in its posterior descending branch. Myocardial bridge almost exclusively occurs in the left anterior descending artery. Reports of a myocardial bridge involving the left circumflex artery are rare, and even rarer is the involvement of the right coronary artery.

Prevalence of myocardial bridge in angiographic population—A study from rural part of western India

“…Although prevalence of MB in various studies has been highly variable, a higher incidence has been observed in patients with hypertrophic obstructive cardiomyopathy (HOCM). [ 5 6 ] It has been observed to be present in up to 86% of cases in autopsy series,[ 7 ] but it was seen only in 0.5–1.6% in most angiographic studies. [ 8 ] Although coronary angiography is considered as a gold standard for diagnosing this entity, other modalities like intravascular sonography and multidetector computed tomography (MDCT) are also useful for diagnosis.…”