Yildiz Okan, Altin Firat H, Tosun Oyku, Iyigun Muzeyyen, Erek Ersin
Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic & Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Department of Pediatric Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic & Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
World J Pediatr Congenit Heart Surg. 2014 Oct;5(4):611-4. doi: 10.1177/2150135114536901.
Myocardial bridging (MB) is a rare coronary anomaly in children which is typically associated with hypertrophic obstructive cardiomyopathy (HCM) or left ventricular hypertrophy. Hypertrophic obstructive cardiomyopathy is the leading cause of sudden cardiac death in young patients, and the association of myocardial ischemia with sudden death has been recognized in patients with HCM. In this report, we describe an 11-year-old boy presented with a history of exertional, nonspecific chest pain and palpitations. Cardiac catheterization revealed MB of the left anterior descending coronary artery with evidence of intramyocardial obstruction during systole. Surgical unroofing of the affected coronary artery segment resulted in complete recovery. Myocardial bridging should be included in the differential diagnosis of children presenting with signs of ischemia.
心肌桥(MB)是儿童中一种罕见的冠状动脉异常,通常与肥厚型梗阻性心肌病(HCM)或左心室肥厚相关。肥厚型梗阻性心肌病是年轻患者心脏性猝死的主要原因,并且在HCM患者中,心肌缺血与猝死之间的关联已得到认可。在本报告中,我们描述了一名11岁男孩,有劳力性、非特异性胸痛和心悸病史。心脏导管检查显示左前降支冠状动脉心肌桥,并有收缩期心肌内梗阻的证据。对受影响的冠状动脉节段进行手术去顶后完全恢复。对于有缺血迹象的儿童,鉴别诊断应包括心肌桥。