Caspian Journal of Internal Medicine
Babol University of Medical Sciences
Thu, Aug 8, 2024
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Volume 11, Issue 1 (1-2020)
Caspian J Intern Med 2020, 11(1): 120-123 |
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Aghajani H, Hosseini K, Alizadeh S, Aghajani R. Challenging case of Muscle Bridge; a 15-year follow-up of a patient. Caspian J Intern Med 2020; 11 (1) :120-123
URL: http://caspjim.com/article-1-1763-en.html
URL: http://caspjim.com/article-1-1763-en.html
Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran , aghajanih@tums.ac.ir
Abstract: (4322 Views)
Background: Anatomically myocardial bridging (MB) consists of either superficial myocardial fibers that traverse over the LAD or deep fibers that encircle the coronary artery. In this study, we present a patient with myocardial bridging, who was primarily diagnosed with coronary artery disease which did not properly respond to full-dose medical treatment but benefited from coronary artery bypass graft (CABG).
Case presentation: In 2017, a 53-year old man was referred to Tehran Heart Center (THC) with complaint of typical chest pain (TCP). In 2003 he had TCP and underwent coronary angiogram (CAG), due to positive non-invasive tests. Muscle-bridge in LAD was diagnosed. In 2007, he was symptomatic and another CAG was done, and percutaneous coronary intervention (PCI) with stenting was performed. In 2008 he became symptomatic and his interventionist, decided to perform another CAG. At that time, he had CABG. He was asymptomatic until 2015, he referred to us with the same TCP and we decided to perform CAG for the fourth time. After two years, again another PCI was done due to in-stent restenosis.
Conclusion: Revascularization should be considered in MB refractory to medical treatment. However, coronary perforation, in-stent restenosis and graft failure are major concerns.
Case presentation: In 2017, a 53-year old man was referred to Tehran Heart Center (THC) with complaint of typical chest pain (TCP). In 2003 he had TCP and underwent coronary angiogram (CAG), due to positive non-invasive tests. Muscle-bridge in LAD was diagnosed. In 2007, he was symptomatic and another CAG was done, and percutaneous coronary intervention (PCI) with stenting was performed. In 2008 he became symptomatic and his interventionist, decided to perform another CAG. At that time, he had CABG. He was asymptomatic until 2015, he referred to us with the same TCP and we decided to perform CAG for the fourth time. After two years, again another PCI was done due to in-stent restenosis.
Conclusion: Revascularization should be considered in MB refractory to medical treatment. However, coronary perforation, in-stent restenosis and graft failure are major concerns.
Keywords: refractory myocardial bridging, percutaneous coronary intervention, coronary artery bypass graft, in-stent restenosis, graft failure
Type of Study: case report |
Subject:
Cardiology
Received: 2019/02/9 | Accepted: 2019/06/24 | Published: 2020/04/18
Received: 2019/02/9 | Accepted: 2019/06/24 | Published: 2020/04/18
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