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核素负荷试验期间,左前降支中段心肌桥表现为短暂性左束支传导阻滞

Myocardial Bridging of Mid-left Anterior Descending Artery (LAD) Presenting As Transient Left Bundle Branch Block During Nuclear Stress Test.

作者信息

Lin Kai Shiang, Kurnick Adam, Goel Ridhima, Gorbut Igal, Friedman Adam, Schrem Ezra, McFarlane Samy I, Bukharovich Inna

机构信息

Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, USA.

Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA.

出版信息

Cureus. 2024 Feb 21;16(2):e54654. doi: 10.7759/cureus.54654. eCollection 2024 Feb.

Abstract

Transient left bundle branch block occurring during a nuclear stress test in the setting of myocardial bridging is a relatively rare finding. We report a case of a 75-year-old male who presented with typical stable angina. Serial troponins were negative, and the electrocardiogram revealed normal sinus rhythm with left ventricular hypertrophy and T-wave inversions in the lateral leads. The nuclear stress test was non-ischemic but showed a transient left bundle branch block associated with chest pain and shortness of breath that occurred right after the administration of regadenoson. Coronary angiography revealed non-obstructive coronary artery disease and a mid-LAD myocardial bridge.

摘要

在心肌桥背景下的核素负荷试验期间出现的短暂性左束支传导阻滞是一种相对罕见的发现。我们报告一例75岁男性患者,表现为典型的稳定型心绞痛。系列肌钙蛋白检查结果为阴性,心电图显示正常窦性心律,伴有左心室肥厚及侧壁导联T波倒置。核素负荷试验未显示缺血,但在注射雷加腺苷后即刻出现与胸痛和呼吸急促相关的短暂性左束支传导阻滞。冠状动脉造影显示非阻塞性冠状动脉疾病及左前降支中段心肌桥。

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