The Long Myocardial Bridging Case Causing Severe Systolic Narrowing; How Should Approach?

Öz

Myocardial bridging, characterized in myocardial systolic blood flow is prevented due to compression of a coronary artery segment. This condition detected by coronary angiography is usually accepted benign. A 52 years old man, who had effort angina for three months, has been diagnosed non-critical plaque and long segment myocardial bridging by coronary angiography. We want to share with this case, non-critical plaque together with myocardial bridging caused stable angina and we aimed to approach to patient with myocardial bridging.

Anahtar Kelimeler

• Myocardial bridging; coronary angiography; angina, stable.

Ciddi Sistolik Darlığa Yol Açan Uzun Miyokardiyal Köprülenme Olgusu; Yaklaşım Nasıl Olmalı?

Öz

Miyokardiyal köprülenmede, miyokart içinde seyreden bir koroner arter segmentine bası nedeniyle sistolik kan akımı engellenmektedir. Koroner anjiyografide tespit edilen bu durum genellikle benign kabul edilir. Üç aydır efor anjinası olan 52 yaşındaki erkek hastanın koroner anjiyografisinde kritik olmayan plak ve uzun segment miyokardiyal köprülenme tespit edildi. Sunacağımız yazıda, kritik olmayan plak birlikteliğindeki miyokardiyal köprülenmenin stabil anjina nedeni olduğu olguyu paylaşarak, miyokardiyal köprülenmeli hastalara yaklaşımı gözden geçirmeyi amaçladık.

Anahtar Kelimeler

• Miyokardiyal köprülenme; koroner anjiyografi; anjina, stabil.

Kaynakça

1. Mohlenkamp S, Hort W, Ge J, Erbel R. Update on myocardial brid- ging. Circulation 2002;106:2616-22.
2. Diefenbach C, Erbel R, Treese N, Bollenbach E, Meyer J. Inciden- ce of myocardial bridges after adrenergic stimulation and decrea- sing afterload in patients with angina pectoris, but normal coronary arteries. Z Kardiol 1994;83:809-15.
3. Wymore P, Yedlicka JW, Garcia-Medina V, Olivari MT, Hunter DW, Castañeda-Zşñiga WR, et al. The incidence of myocardial bridges in heart transplants. Cardiovasc Intervent Radiol 1989;12:202-6.
4. Sorajja P, Ommen SR, Nishimura RA, Gersh BJ, Tajik AJ, Holmes DR. Myocardial bridging in adult patients with hypertrophic cardi- omyopathy. J Am Coll Cardiol 2003;42:889-94.
5. Ishikawa Y, Kawawa Y, Kohda E, Shimada K, Ishii T. Significance of the anatomical propertiesof a myocardial bridge in coronary he- art disease. Circ J 2011;75:1559-66.
6. Ishikawa Y, Akasaka Y, Suzuki K, Fujiwara M, Ogawa T, Yamazaki K, et al. Anatomic properties of myocardial bridge predisposing to myocardial infarction. Circulation 2009;120:376-83.
7. Kalaria VG, Koradia N, Breall JA. Myocardial bridge: a clinical re- view. Cathet Cardiovasc Interv 2002;57:552-6.
8. Schwarz ER, Klues HG, vom Dahl J, Klein I, Krebs W, Hanrath P. Functional, angiographic and intracoronary Doppler flow charac- teristics in symptomatic patients with myocardial bridging: effect of short-term intravenous beta-blocker medication. J Am Coll Cardiol 1996;27:1637-45.

9. Klues HG, Schwarz ER, vom Dahl J, Reffelmann T, Reul H, Pott- hast K, et al. Disturbed intracoronary hemodynamics in myocardi- al bridging. Early normalization by intracoronary stent placement. Circulation 1997;96:2905-13.
10. Iversen S, Hake U, Mayer E, Erbel R, Diefenbach C, Oelert H. Surgical treatment of myocardial bridging causing coronary artery obstruction. Scand J Thorac Cardiovasc Surg 1992;26:107-11.