Fathallah Ibrahim, Qatza Ayham, Al-Talep Ahmed, Yousef Reham, Hasn Rami Asef
Faculty of Medicine, Al-Baath University, Homs, Syria.
Faculty of Medicine, Hama University, Hama, Syria.
Radiol Case Rep. 2025 Jan 18;20(4):1882-1887. doi: 10.1016/j.radcr.2025.01.003. eCollection 2025 Apr.
Complete heart block (CHB) is a disruption in electrical impulses to travel from atria to ventricles and can rarely be caused by myocardial bridging (MB), where cardiac tissue compresses a coronary artery during systole. The incidence of MB ranges from 0.5 % to 16 % in coronary angiography patients. This case report presents a 30-year-old female presented with dizziness, shortness of breath, and chest pain, diagnosed with third-degree AV block. Echocardiography revealed interventricular septal thickening and mild mitral regurgitation. Coronary angiography identified myocardial bridging in the mid LAD artery causing significant systolic stenosis. After ruling out reversible causes, a dual-chamber permanent pacemaker was implanted due to persistent heart block. The patient remained stable postprocedure, with decreasing cardiac biomarkers, and was discharged symptom-free with a follow-up appointment scheduled. MB can lead to serious cardiovascular events, including myocardial infarction and CHB. Clinicians must recognize the risks associated with MB and maintain a high suspicion for CHB to ensure timely management. Further studies are needed to clarify the CHB-MB relationship and improve patient outcomes.
完全性心脏传导阻滞（CHB）是指电冲动从心房传导至心室的过程发生中断，很少由心肌桥（MB）引起，即心脏组织在收缩期压迫冠状动脉。在接受冠状动脉造影的患者中，心肌桥的发生率为0.5%至16%。本病例报告介绍了一名30岁女性，出现头晕、气短和胸痛症状，被诊断为三度房室传导阻滞。超声心动图显示室间隔增厚和轻度二尖瓣反流。冠状动脉造影发现左前降支动脉中段存在心肌桥，导致明显的收缩期狭窄。在排除可逆性病因后，由于持续性心脏传导阻滞，植入了双腔永久性起搏器。术后患者病情稳定，心脏生物标志物下降，无症状出院，并安排了随访。心肌桥可导致严重的心血管事件，包括心肌梗死和完全性心脏传导阻滞。临床医生必须认识到与心肌桥相关的风险，并对完全性心脏传导阻滞保持高度怀疑，以确保及时治疗。需要进一步研究以阐明完全性心脏传导阻滞与心肌桥的关系并改善患者预后。
