Kracoff O H, Ovsyshcher I, Gueron M
Division of Cardiology, Soroka University Hospital, Beer-Sheva, Israel.
Chest. 1987 Dec;92(6):1113-5. doi: 10.1378/chest.92.6.1113.
A 35-year-old man, with recent onset angina, developed recurrent episodes of syncope due to ventricular tachycardia. His coronary angiogram showed normal coronary arteries and myocardial bridging of the left anterior descending causing severe systolic milking effect. Extensive invasive and noninvasive investigations did not reveal cardiac pathology other than the myocardial bridging. Electrophysiologic studies, not previously reported in myocardial bridging, demonstrated inducible sustained ventricular tachycardia at a rate of 280 beats/min. The possible relationship between the arrhythmia and the myocardial bridge is suggested. Combined medical treatment with amiodarone and diltiazem proved to be an effective alternative to surgical myotomy of the bridge.
一名35岁男性，近期出现心绞痛，因室性心动过速反复发作晕厥。他的冠状动脉造影显示冠状动脉正常，左前降支存在心肌桥，导致严重的收缩期挤奶效应。除心肌桥外，广泛的有创和无创检查未发现心脏病变。电生理研究（此前心肌桥未见相关报道）显示可诱发持续室性心动过速，心率为280次/分钟。提示了心律失常与心肌桥之间可能的关系。胺碘酮和地尔硫䓬联合药物治疗被证明是桥肌切开术的有效替代方案。
