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心肌桥——心肌梗死的罕见病因;病例报告及文献综述

Myocardial Bridging, Unusual Cause of Myocardial Infarction; Case Report and Review of Literature.

作者信息

Daba Merga, Bineyam Dawit, Yohannes Ibraist, Yohannes Beniam, Waktola Rabirra, Bedada Eshetu

机构信息

Department of Internal Medicine College of Health Sciences, Addis Ababa University Addis Ababa Ethiopia.

Department of Radiology and MRT St. Paul Hospital Millennium Medical College Addis Ababa Ethiopia.

出版信息

Clin Case Rep. 2025 Jan 10;13(1):e70055. doi: 10.1002/ccr3.70055. eCollection 2025 Jan.

Abstract

Myocardial bridging is a common coronary anomaly. Although it is considered to be a benign condition, it can rarely be complicated by myocardial infarction. Clinicians should be suspicious of myocardial bridging as an etiology of myocardial infarction when other more common etiologies have been excluded. High resolution CT angiography is the gold standard for diagnostic evaluation, with the length and depth of the bridge, and response to conservative therapies guiding clinical decision making on surgical correction. Myocardial bridging is a congenital coronary anomaly in which the coronary arteries pass through the heart muscle rather than lying on its surface. It is typically a benign condition, and most patients are asymptomatic. However, some may experience symptoms of angina. In rare cases, patients can present with myocardial ischemia or infarction. In this report, we present the case of a 38-year-old female who presented with a 2-month history of chest pain. Further evaluation with coronary computed tomography angiography (CCTA) revealed myocardial bridging. Subsequently, she developed a myocardial infarction, a rare complication of this condition. We discuss this uncommon complication of a common anomaly.

摘要

心肌桥是一种常见的冠状动脉异常。尽管它被认为是一种良性病症,但极少会并发心肌梗死。当排除了其他更常见的病因后,临床医生应怀疑心肌桥是心肌梗死的病因。高分辨率CT血管造影是诊断评估的金标准,桥的长度和深度以及对保守治疗的反应指导着手术矫正的临床决策。心肌桥是一种先天性冠状动脉异常,其中冠状动脉穿过心肌而不是位于心肌表面。它通常是一种良性病症,大多数患者无症状。然而,一些患者可能会出现心绞痛症状。在罕见情况下,患者可出现心肌缺血或梗死。在本报告中,我们介绍了一名38岁女性的病例,她有2个月的胸痛病史。通过冠状动脉计算机断层扫描血管造影(CCTA)进一步评估发现了心肌桥。随后,她发生了心肌梗死,这是这种病症的一种罕见并发症。我们讨论了这种常见异常的不常见并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fc/11720737/2858b7910365/CCR3-13-e70055-g001.jpg

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