Myocardial Bridging As One of the Causes of Atypical Chest Pain in Young Women

Overview

Journal Egypt Heart J

Publisher Springer

Specialty Cardiology & Vascular Diseases

Date 2018 Apr 7

PMID 29622983

Authors

M Jukic

L Pavic

I Bitunjac

T Jukic

M Milosevic

D Lovric

M Lovric Bencic

Affiliations

Soon will be listed here.

Abstract

Introduction: Myocardial bridging is congenital anomaly which usually has benign prognosis but there are also reports suggesting that it can be associated with ischemic clinical syndromes presenting with chest pain. Coronary computed tomography angiography is a well-established method for detecting myocardial bridging. However, clinical significance of this anomaly still remains unclear.

Methods: We studied 977 patients who presented with recurrent typical or atypical chest pain in outpatient clinic. All patients have undergone detailed clinical examination, ECG stress testing and coronary computed tomography angiography.

Results: Highest positive prediction for having myocardial bridging was for patients presenting with atypical chest pain with negative ECG stress test and who were younger women.

Conclusion: Coronary computed tomography angiography may be preferable method for evaluation of chest pain in younger women presenting with atypical chest pain.

References

Morales A, Romanelli R, BOUCEK R . The mural left anterior descending coronary artery, strenuous exercise and sudden death. Circulation. 1980; 62(2):230-7. DOI: 10.1161/01.cir.62.2.230. View

Sorajja P, Ommen S, Nishimura R, Gersh B, Tajik A, Holmes D . Myocardial bridging in adult patients with hypertrophic cardiomyopathy. J Am Coll Cardiol. 2003; 42(5):889-94. DOI: 10.1016/s0735-1097(03)00854-4. View

Noble J, Bourassa M, PETITCLERC R, DYRDA I . Myocardial bridging and milking effect of the left anterior descending coronary artery: normal variant or obstruction?. Am J Cardiol. 1976; 37(7):993-9. DOI: 10.1016/0002-9149(76)90414-8. View

Hostiuc S, Curca G, Dermengiu D, Dermengiu S, Hostiuc M, Rusu M . Morphological changes associated with hemodynamically significant myocardial bridges in sudden cardiac death. Thorac Cardiovasc Surg. 2011; 59(7):393-8. DOI: 10.1055/s-0030-1270703. View

Leschka S, Scheffel H, Desbiolles L, Plass A, Gaemperli O, Valenta I . Image quality and reconstruction intervals of dual-source CT coronary angiography: recommendations for ECG-pulsing windowing. Invest Radiol. 2007; 42(8):543-9. DOI: 10.1097/RLI.0b013e31803b93cf. View

Kramer J, Kitazume H, Proudfit W, SONES Jr F . Clinical significance of isolated coronary bridges: benign and frequent condition involving the left anterior descending artery. Am Heart J. 1982; 103(2):283-8. DOI: 10.1016/0002-8703(82)90500-2. View

Ishikawa Y, Akasaka Y, Suzuki K, Fujiwara M, Ogawa T, Yamazaki K . Anatomic properties of myocardial bridge predisposing to myocardial infarction. Circulation. 2009; 120(5):376-83. DOI: 10.1161/CIRCULATIONAHA.108.820720. View

de Giorgio F, Grassi V, Polacco M, Pascali V, dAloja E, Arena V . Myocardial bridging and sudden cardiac death: is the actual classification exhaustive?. Int J Cardiol. 2014; 172(3):e383-4. DOI: 10.1016/j.ijcard.2013.12.286. View

Faruqui A, MALOY W, Felner J, SCHLANT R, LOGAN W, SYMBAS P . Symptomatic myocardial bridging of coronary artery. Am J Cardiol. 1978; 41(7):1305-10. DOI: 10.1016/0002-9149(78)90890-1. View

10.

Abdou M . Myocardial bridging causing ischemia and recurrent chest pain: a case report. Int Arch Med. 2011; 4:24. PMC: 3224392. DOI: 10.1186/1755-7682-4-24. View

11.

Angelini P, Trivellato M, Donis J, Leachman R . Myocardial bridges: a review. Prog Cardiovasc Dis. 1983; 26(1):75-88. DOI: 10.1016/0033-0620(83)90019-1. View

12.

Hamoir X, Flohr T, Hamoir V, Labaki L, Tricquet J, Duhamel A . Coronary arteries: assessment of image quality and optimal reconstruction window in retrospective ECG-gated multislice CT at 375-ms gantry rotation time. Eur Radiol. 2004; 15(2):296-304. DOI: 10.1007/s00330-004-2541-8. View

13.

Iskandrian A, Nallamothu N, Heo J . Nonatherosclerotic causes of myocardial ischemia. J Nucl Cardiol. 1996; 3(5):428-35. DOI: 10.1016/s1071-3581(96)90079-3. View

14.

Dewey M, Rief M, Martus P, Kendziora B, Feger S, Dreger H . Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial. BMJ. 2016; 355:i5441. PMC: 5076567. DOI: 10.1136/bmj.i5441. View

15.

Schmitt R, Froehner S, Brunn J, Wagner M, Brunner H, Cherevatyy O . Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography. Eur Radiol. 2005; 15(6):1110-21. DOI: 10.1007/s00330-005-2707-z. View

16.

La Grutta L, Runza G, Lo Re G, Galia M, Alaimo V, Grassedonio E . Prevalence of myocardial bridging and correlation with coronary atherosclerosis studied with 64-slice CT coronary angiography. Radiol Med. 2009; 114(7):1024-36. DOI: 10.1007/s11547-009-0446-y. View

17.

Balady G, Bricker J, Chaitman B, Fletcher G, Froelicher V, Mark D . ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation. 2002; 106(14):1883-92. DOI: 10.1161/01.cir.0000034670.06526.15. View

18.

Hongo Y, Tada H, Ito K, Yasumura Y, Miyatake K, Yamagishi M . Augmentation of vessel squeezing at coronary-myocardial bridge by nitroglycerin: study by quantitative coronary angiography and intravascular ultrasound. Am Heart J. 1999; 138(2 Pt 1):345-50. DOI: 10.1016/s0002-8703(99)70123-7. View

19.

Utuk O, Bilge A, Bayturan O, Tikiz H, Tavli T, Tezcan U . Thrombosis of a coronary artery related to the myocardial bridging. Heart Lung Circ. 2009; 19(8):481-2. DOI: 10.1016/j.hlc.2009.08.006. View

20.

Prazeres C, Cury R, Carneiro A, Rochitte C . Coronary computed tomography angiography in the assessment of acute chest pain in the emergency room. Arq Bras Cardiol. 2013; 101(6):562-9. PMC: 4106815. DOI: 10.5935/abc.20130208. View