Myocardial bridge as a cause of acute ischaemia. A case report and literature review

Myocardial bridges consist of muscle fiber bundles Lining an epicardial cor onary artery for a variable distance. They are a relatively common finding, with incidence changing on the basis of the study method used (angiographi c/necropsy). Although myocardial bridges are usually associated with a beni gn prognosis, being in many cases asymptomatic and only found by chance, th eir presence has also been considered a cause of angina, malignant arrhythm ia, myocardial infarction and sudden death. They are diagnosed in vivo by a ngiography when a systolic compression of a coronary artery which disappear s during diastole is evidenced. We report the case of a patient with electr ocardiographic signs of severe ischemia in the territory of the anterior de scending artery, which was initially assessed as myocardial infarction and treated as such. Eventually, the ECG returned to normal, and no new Q waves of necrosis occurred. An angiohe-modynamic study confirmed the existence o f an isolated muscular bridge over the middle third of the anterior descend ing artery, with no other associated coronary lesions.