Choudhry Faiza, Fackler Michael, Patel Mithil, Patel Vijay, Arnautovic Jelena
Ascension Macomb-Oakland Hospital.
Henry Ford Macomb Hospital.
Spartan Med Res J. 2019 Jul 1;4(1):8999. doi: 10.51894/001c.8999.
A myocardial bridge has traditionally been considered a benign condition characterized by an atypical intramyocardial route of a segment of one of the major coronary arteries. However, the clinical complications of myocardial bridges can be dangerous. These potential complications include acute coronary syndromes, arrhythmias, ventricular dysfunction, and sudden death. Myocardial bridges are suspected to be adjuvant of Kounis syndrome, which is defined as an acute coronary syndrome caused by an allergic reaction. Due to high epidemiologic prevalence, clinical suspicion of a myocardial bridge should be considered in atypical and typical presentations of chest pain, especially in patients with low-risk factors for atherosclerotic disease. A male in their late 30's presented with non-ST elevation myocardial infarction suspected to be secondary to Kounis syndrome after gadobenate dimeglumine contrast media was used for an imaging study. His clinical presentation was further complicated when he was found to have a mid-left anterior descending coronary artery myocardial bridge.
传统上，心肌桥被认为是一种良性病症，其特征为主要冠状动脉之一的一段走行于心肌内的非典型路径。然而，心肌桥的临床并发症可能很危险。这些潜在并发症包括急性冠脉综合征、心律失常、心室功能障碍和猝死。心肌桥被怀疑是库尼斯综合征的辅助因素，库尼斯综合征定义为由过敏反应引起的急性冠脉综合征。由于流行病学患病率较高，对于非典型和典型胸痛表现，尤其是动脉粥样硬化疾病低风险因素的患者，应考虑临床怀疑心肌桥。一名30多岁的男性在使用钆贝葡胺造影剂进行影像学检查后，出现疑似继发于库尼斯综合征的非ST段抬高型心肌梗死。当发现他左前降支冠状动脉中段有心肌桥时，其临床表现进一步复杂化。
