Myocardial Bridging: Abnormal Coronary Artery Anatomy Causes Unusual Chest Pain

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American Journal of Case Reports

The anatomy of the coronary arteries varies within the population. This is a case of a 27-year-old woman who had a unique anatomy of the coronary artery, which caused her to experience unusual chest pain.

She presented with pain on the left side of her chest. The pain occurred at rest and its duration was approximately 30 minutes. However, there were no other signs or symptoms. This condition is known as myocardial bridging.

Myocardial bridging: no underlying cause

The doctors performed all the baseline investigations on the young woman, yet they found no underlying cause. Although, her reports did show raised troponin levels. Moreover, these levels did not increase during her hospital stay.

The diagnosis

Finally, the doctors made the decision to perform an invasive investigation. This procedure is performed using a tube, also known as a catheter. The heart and its vessels are reached using this procedure and several diseases can be diagnosed with it. During this procedure, the doctors made the diagnosis of myocardial bridging.

Myocardial bridging: an anomaly

Myocardial bridging is a deviation from the normal route that the coronary artery follows. It penetrates into the muscle wall of the heart. Therefore, the muscle wall can compress the coronary artery. This can lead to obstruction in the blood flow to the heart. This causes atypical chest pain, rhythmic dysfunction of the heart (arrhythmia), and death of the myocardial tissue (infarction).

Treatment

The doctors prescribed Aspirin and a calcium channel blocker to the woman. Fortunately, this treatment helped control her symptoms.

Follow-up

The doctors asked her to follow up within a few weeks. During one of the visits, she complained of feeling light-headed. Thus, the doctors switched her to another medicine.

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