CASE REPORT
Interventional Cardiology
doi: 10.25005/2074-0581-2026-28-2-562-569
MYOCARDIAL BRIDGE AS A CAUSE OF CHRONIC CORONARY ARTERY DISEASE: A CLINICAL CASE

I.E. NIKOLAEVA1,2, A.A. SAMORODOV2, I.R. MUSTAFIN2, T.S. SAGATDINOV3, D.R. IBRAGIMOV4

1Department of X-ray Endovascular Diagnostics and Treatment, Bashkir State Medical University, Ufa, Russian Federation
2Department of X-ray Endovascular Methods of Diagnosis and Treatment No. 1, Republican Cardiological Center, Ufa, Russian Federation
3Department of Hospital and Cardiovascular Surgery, Bashkir State Medical University, Ufa, Russian Federation
4Department of Faculty Surgery, Bashkir State Medical University, Ufa, Russian Federation

A myocardial bridge (MB) is a congenital anomaly in which a coronary artery passes within the myocardium. Despite its frequently benign course, under certain conditions, MB may cause severe myocardial ischemia, particularly in young patients without classical risk factors for atherosclerosis. This article presents a clinical observation of a 40-year-old patient who complained of pressing retrosternal pain during physical exertion. Multislice computed tomography coronary angiography (MSCT-CAG), an exercise stress test, and selective coronary angiography (CAG) were used for diagnosis. MSCT-CAG revealed stenosis of the left anterior descending artery (LAD) of up to 75-80%. Selective CAG diagnosed occlusion of the proximal third of the LAD; the distal vessel bed was filled via collaterals. Percutaneous coronary intervention (PCI) was performed with recanalization of the occlusion and stenting of the LAD. After successful recanalization and stenting of the occluded segment, a myocardial bridge with systolic narrowing of up to 40% was visualized in the middle third of the LAD. Thus, the MB, which had not been detected initially, was recognized as a key factor in the development of the proximal lesion and subsequent arterial occlusion. Positive clinical dynamics were achieved after the intervention. The described case demonstrates that MB may be the main cause of coronary artery disease (CAD) and coronary artery occlusion in young patients. Selective CAG is of decisive importance for verifying the diagnosis.  Timely myocardial revascularization and adequate pharmacotherapy enable a favorable outcome.

Keywords: Myocardial bridge, ischemic heart disease, coronary angiography, occlusion, left anterior descending artery, clinical observation.

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Authors' information:

Nikolaeva Irina Evgenievna,
Candidate of Medical Sciences, Associate Professor, Head of the Department of X-ray Endovascular Diagnostics and Treatment, Bashkir State Medical University; Chief Physician, Republican Cardiological Center
Scopus ID: 52664137400
ORCID ID: 0000-0001-7641-2317
Author ID: 396106
E-mail: NikolaevaIE@doctorrb.ru

Samorodov Anton Aleksandrovich,
Physician, Department of X-ray Endovascular Methods of Diagnosis and Treatment No. 1, Republican Cardiology Center
ORCID ID: 0000-0002-9609-6101
E-mail: 2metrr@gmail.com

Mustafin Ilfir Radikovich,
Head of the Department of X-ray Endovascular Methods of Diagnosis and Treatment No. 1, Republican Cardiological Center
ORCID ID: 0009-0002-0629-8066
E-mail: i@docilfir.ru

Sagatdinov Timur Shamilevich,
Assistant Professor of the Department of Hospital and Cardiovascular Surgery, Bashkir State Medical University
Researcher ID: AAY-1225-2021
Scopus ID: 57280068100
ORCID ID: 0000-0002-5140-2160
SPIN: 4760-9529
Author ID: 991964
E-mail: t.sagatdinov@mail.ru

Ibragimov Denis Radikovich,
Candidate of Medical Sciences, Associate Professor of the Department of Faculty Surgery, Bashkir State Medical University
ORCID ID: 0000-0003-4487-8061
SPIN: 6191-6802
Author ID: 969031
E-mail: ezikkk@icloud.com

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Ibragimov Denis Radikovich
Candidate of Medical Sciences, Associate Professor of the Department of Fac- ulty Surgery, Bashkir State Medical University

450008, Russian Federation, Ufa, Lenin str., 3

Tel.: +7 (917) 4151795

E-mail: ezikkk@icloud.com


This work is licensed under a Creative Commons Attribution 4.0 International License.

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