Myocardial ischemia caused by the synergistic effect of myocardial bridge and moderate stenosis: case report

Clinical events such as angina pectoris, acute coronary syndrome, and sudden death caused by myocardial bridge (MB) have attracted increasing attention. It is still a challenge to diagnose whether MB can cause the symptoms of patients with MB. For most MB patients, medication remains the primary treatment.

This article reports a case of chest pain in a patient with MB in the middle segment of the left anterior descending artery (LAD_m) with moderate stenosis in the proximal segment (LAD_p). Through functional assessment, we found that neither MB nor fixed stenosis had sufficient effect on coronary blood flow to cause myocardial ischemia, but their synergistic effect resulted in myocardial ischemia. Finally, a stent was implanted in LAD_p and good clinical results were achieved.

For symptomatic patients with MB combined with fixed stenosis, functional evaluation may be necessary, which has significant guiding significance for treatment strategy selection. For asymptomatic patients, early detection of myocardial ischemia may also improve the prognosis of patients.