Symptomatic myocardial bridging: a frequently occurring coronary variation can cause severe myocardial ischaemia in affected children with underlying cardiac conditions

2018 ◽  
Vol 28 (6) ◽  
pp. 826-831 ◽  
Author(s):  
Alexandra Kiess ◽  
Marcel Vollroth ◽  
Farhad Bakhtiary ◽  
Hiroshi Seki ◽  
Martin Kostelka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Myocardial Ischaemia ◽  
Heart Diseases ◽  
Young Patients ◽  
Myocardial Bridging ◽  
Dilative Cardiomyopathy ◽  
Reduce Heart Rate ◽  
Β Blocker ◽  
Ramus Interventricularis Anterior ◽  
St Segments

AbstractMyocardial bridging is a congenital coronary artery anomaly in which the coronary artery has a partly “tunnelled” intramyocardial course. This tunnelling leads to compression of the affected vessel segment during ventricular systole. It is considered to be a benign variation of the norm in about 25% of the population caused by an aberrancy of embryologic coronary development. The bridging is also thought to cause severe cardiac conditions in a few of those affected. The series of six young patients presented here is the largest series so far to report on symptomatic myocardial bridging in children with different underlying heart diseases. All patients recently presented to our centre with signs of myocardial ischaemia. They subsequently underwent coronary angiography, which revealed myocardial bridging of the ramus interventricularis anterior. In all patients, therapy with β blockers was started to reduce heart rate and myocardial contractility. β Blocker treatment was also given in order to prolong diastole and improve coronary artery blood flow. Two patients underwent surgical exposure of the involved coronary segment: a 2-year-old boy because of recurrent, severe myocardial ischaemia in combination with a reduction of general health, changes in ST-segments, and the presence of a dilative cardiomyopathy; and a 13-year-old girl because of evidence of myocardial ischaemia during exercise testing after surviving sudden cardiac death. Surgery was successful and recovery was complete and uneventful. The presented series shows that myocardial bridging can be symptomatic and may require urgent treatment and even surgical intervention in early childhood in rare cases.

scholarly journals Double Coronary Artery Anomaly in an Elderly Asymptomatic Patient with Positive Electrocardiogram Stress Test

2013 ◽  
Vol 3 ◽  
pp. 68
Author(s):  
Giuseppe Cannavale ◽  
Fabiana Trulli ◽  
Marco Colotto
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Stress Test ◽  
Young Patients ◽  
Coronary Artery Anomaly ◽  
Myocardial Bridging ◽  
Professional Soccer ◽  
Computed Tomography Images ◽  
Cardiac Symptoms ◽  
The Right

Malignant coronary artery anomalies and myocardial bridging are more common findings in young patients with cardiac symptoms, but these two associated yet different types of anomalies in an elderly patient has been rarely described. The following case describes the diagnostic use of 128-slice coronary-computed tomography images of an 82-year-old male, former professional soccer player, who reached the age of 82 years without any symptoms of coronary heart disease. In this patient, an association of a malignant coronary artery anomaly of origin and course (left descending coronary artery originating from the right sinus of valsalva running between the aorta and the right ventricular outflow tract), together with a long myocardial bridging over the obtuse marginal branch was diagnosed by multi-slice computed tomography thanks to an initial positive electrocardiogram screening stress test.

scholarly journals Coronary dominance pattern in Myocardial bridged hearts

2020 ◽  
Vol 11 (1) ◽  
pp. 1263-1266
Author(s):  
Mohandas G.V. ◽  
Sitansu Ku.Panda
Keyword(s):  
Coronary Artery ◽  
Heart Diseases ◽  
Ischemic Heart ◽  
Myocardial Bridging ◽  
Myocardial Bridge ◽  
Inferior Surface ◽  
Coronary Syndrome ◽  
The Right ◽  
Dominance Pattern ◽  
Coronary Dominance

Posterior interventricular artery (PIA) present in the posterior interventricular groove over the inferior surface of the heart. Human hearts consist of either  Right coronary predominance or Left coronary predominance. Left coronary predominant people are more prone to get ischemic heart diseases. In left coronary predominance entire left ventricle except a part of the right ventricle adjoining anterior interventricular groove supplied by the left main coronary artery. Left coronary dominance has a poor prognosis in acute coronary syndrome when compared with the right coronary predominance. Myocardial bridging may be benign or malignant. So myocardial bridging with left coronary dominance may be a risk factor to the ischemic heart disease. The aim of the present study is to find out the coronary dominance pattern in myocardial bridged hearts in cadavers. Ninety cadaveric hearts were procured from the Department of Anatomy, IMS & SUM Hospital Bhubaneswar. After a simple dissecting procedure, myocardial bridges and coronary dominance patterns were observed. Myocardial bridging was present over the left anterior interventricular artery in 51(56.7%) hearts. Out of 51 myocardial bridged hearts, right coronary predominance is present in 45 (88.24%) hearts and left coronary predominance present in 6(11.76%) hearts.  Along with the left dominance, if myocardial bridge present over the left epicardial coronary artery, there may be an increased frequency of myocardial ischemia.

CORONARY ARTERY LESIONS IN PATIENTS OVER 50 YEAR OLD WITH VALVULAR HEART DISEASES INDICATED FOR VALVE SURGERY

2016 ◽  
pp. 20-24
Author(s):  
Bang Giap Vo ◽  
Anh Binh Ho ◽  
Van Minh Huynh
Keyword(s):  
Coronary Artery ◽  
Mitral Valve ◽  
Heart Valve ◽  
Right Coronary Artery ◽  
Heart Diseases ◽  
Heart Valve Diseases ◽  
Coronary Artery Lesions ◽  
Circumflex Coronary Artery ◽  
Valvular Heart Diseases ◽  
Valve Diseases

Objectives: To investigate the features of coronary artery lesions in patients over 50 with heart valve diseases and to find out the relationship between the levels of coronary artery lesions and heart valve diseases. Results: In patients over 50 year old with heart valve diseases, the rate of significant coronary artery lesions is 55.5%. In which, significant lesions in the group of both mitral and aorta valve diseases is 44.19%, only mitral valve diseases is of 70%, only aortic valve diseases is of 51.85%. There is a relationship between the severity of mitral valve diseases and right coronary artery lesions (OR 3.74: 1.64 to 8.5, p = 0.0017) and circumflex coronary artery lesions (OR 2.59: 1.16 to 5.75, p = 0.0192). The severity of heart valve lesions in significant coronary artery lesions group is higher than insignificant coronary artery lesions group or normal group. Conclusion: Coronary artery lesions is common in patients > 50 years old with heart valve diseases, there is a relationship between the severity of mitral valve diseases and and right coronary artery lesions and circumflex coronary artery lesions. Key words: coronary artery lesions, mitral valvediseases

scholarly journals Challenges in Evaluation and Management of Children with Myocardial Bridging

Cardiology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Nurdan Erol
Keyword(s):  
Congenital Anomaly ◽  
Coronary Artery ◽  
Case Reports ◽  
Case Series ◽  
Diagnosis And Treatment ◽  
Myocardial Bridging ◽  
Small Case Series ◽  
Adults And Children ◽  
Artery Branch

Myocardial bridging (MB) is a congenital anomaly where a coronary artery branch or group of branches extends inside a tunnel consisting of myocardium. Although it is mostly considered “benign,” it is reported that MB may lead to significant cardiac problems and sudden cardiac deaths. While it is a congenital anomaly, its symptoms usually arise at further ages rather than childhood. The literature on MB in children is in the form of case reports or small case series. This is why pediatric cases are assessed in the light of information obtained from adults. This review compiled the literature on MB in adults and children and compared it, as well as discussing questions arising regarding the clinic, diagnosis, and treatment of MB.

scholarly journals Role of Selected miRNAs as Diagnostic and Prognostic Biomarkers in Cardiovascular Diseases, Including Coronary Artery Disease, Myocardial Infarction and Atherosclerosis

2021 ◽  
Vol 8 (2) ◽  
pp. 22
Author(s):  
Rashid Mir ◽  
Imadeldin Elfaki ◽  
Naina Khullar ◽  
Ajaz Ahmad Waza ◽  
Chandan Jha ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Diseases ◽  
Cardiac Dysfunction ◽  
Heart Diseases ◽  
Prognostic Biomarkers ◽  
Apoptotic Bodies ◽  
Artery Disease

Cardiovascular diseases are the leading cause of death worldwide in different cohorts. It is well known that miRNAs have a crucial role in regulating the development of cardiovascular physiology, thus impacting the pathophysiology of heart diseases. MiRNAs also have been reported to be associated with cardiac reactions, leading to myocardial infarction (MCI) and ultimately heart failure (HF). To prevent these heart diseases, proper and timely diagnosis of cardiac dysfunction is pivotal. Though there are many symptoms associated with an irregular heart condition and though there are some biomarkers available that may indicate heart disease, authentic, specific and sensitive markers are the need of the hour. In recent times, miRNAs have proven to be promising candidates in this regard. They are potent biomarkers as they can be easily detected in body fluids (blood, urine, etc.) due to their remarkable stability and presence in apoptotic bodies and exosomes. Existing studies suggest the role of miRNAs as valuable biomarkers. A single biomarker may be insufficient to diagnose coronary artery disease (CAD) or acute myocardial infarction (AMI); thus, a combination of different miRNAs may prove fruitful. Therefore, this review aims to highlight the role of circulating miRNA as diagnostic and prognostic biomarkers in cardiovascular diseases such as coronary artery disease (CAD), myocardial infarction (MI) and atherosclerosis.

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