Departments of Internal Medicine, College of Medicine, School of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea.
BMC Cardiovasc Disord. 2021 Apr 14;21(1):178. doi: 10.1186/s12872-021-01975-x.
Myocardial bridging is a congenital anomaly defined as a segment of epicardial coronary arteries running through the myocardium. Various complications related to myocardial bridging have been reported, but at present, cardiac arrest has rarely been reported.
We report one case of a patient who was successfully resuscitated from ventricular fibrillation cardiac arrest and was diagnosed with myocardial bridging accompanied by myocardial ischaemia. A 50-year-old woman who had been resuscitated from cardiac arrest transferred to our institution for evaluation and management of out-of-hospital cardiac arrest. We confirmed the diagnosis of significant myocardial bridging with evident myocardial ischaemia by coronary angiography, resting echocardiography and heart MRI. Vasospasm was thought to be a trigger factor judging from the transient ST elevation on electrocardiography. In addition, the finding of septal buckling was detected for the first time throughout the whole cardiac cycle by resting echocardiography in MB.
We report a rare case of survival after out-of-hospital cardiac arrest that might be caused by significant myocardial bridging-induced myocardial ischaemia, which was objectively confirmed by echocardiography and heart MRI. Although myocardial bridging is often overlooked as an aetiology for sudden cardiac death, this case highlights the importance of expanding the differential diagnosis to myocardial bridging in the work-up for the cause of sudden cardiac death.
心肌桥是一种先天性异常，定义为一段心外膜冠状动脉穿行于心肌中。与心肌桥相关的各种并发症已有报道，但目前心脏骤停很少见。
我们报告了一例成功从心室颤动心脏骤停中复苏的患者，诊断为伴有心肌缺血的心肌桥。一名 50 岁女性因心脏骤停复苏后转入我院，评估和管理院外心脏骤停。我们通过冠状动脉造影、静息超声心动图和心脏 MRI 证实了明显的心肌桥伴明显心肌缺血的诊断。从心电图上短暂的 ST 段抬高判断，血管痉挛可能是一个触发因素。此外，在 MB 中，静息超声心动图首次在整个心动周期中检测到间隔折曲。
我们报告了一例罕见的院外心脏骤停后存活的病例，可能是由明显的心肌桥引起的心肌缺血所致，这一情况通过超声心动图和心脏 MRI 得到了客观证实。尽管心肌桥常被忽视为导致心源性猝死的病因，但本病例强调了在寻找心源性猝死病因时，将心肌桥纳入鉴别诊断的重要性。
